PURPOSE: Despite the well-known public health benefits of vaccination, increasing public concern about the safety of childhood vaccinations has led some parents to refuse or hesitate having their children immunized. The purpose of this study was to identify the subjectivity of parents toward refusal of childhood vaccination. METHODS: Q-methodology, in which subjective viewpoints are explored and analyzed using a combination of quantitative and qualitative techniques, was used. Thirty-five participants were asked to rank 42 statements on diverse issues of childhood vaccination according to a continuous 9-point scale ranging from -4 for strongly disagree to +4 for strongly agree. Collected data was analyzed using the PC-QUANAL program. RESULTS: The results revealed three discrete groups of parents in the refusal of children's immunization: type I, distrust; type II, concern about side effects, and type III, belief that vaccinations are unnecessary. CONCLUSION: Special nurse counselors who can provide correct information about vaccination based on the three types should be part of the government policy. Customized education programs to shift viewpoints should be also redeveloped according to the results in this study.
Child ; Counseling ; Disulfiram ; Humans ; Parents ; Public Health ; Rejection (Psychology) ; Vaccination

Objectives: Due to the prolonged coronavirus disease 2019 pandemic, prioritizing the safety and well-being of essential workers, who play a vital role in enabling contactless living, is paramount. This study aims to check oral health status and related factors in platform workers. Methods: The participants, who are platform workers in Seoul, were divided into three occupations: replacement driver, parcel, and delivery. The survey included oral examination and health-related questionnaires from August to November 2022. Finally, 204 platform workers in Seoul participated in the study. The socio-demographic characteristics of participants, such as sex, age, education level, and health behavior, were analyzed. A chi-square test and logistic regression analysis were performed to investigate the socio-demographic factors related to the need for dentures. Results: Most participants were men (97.5%), and in the age of 50s (33.8%). In total, the proportion of the need for dentures was 40.2%. It was high in the group of parcel, the 50s age group, and people without experience of the oral exam last year (P<0.05). The probability of needing dentures was 9.7 times higher in the 50s than in the 30s, and 2.3 times higher in the group without oral exam experience last year than the group with that experience. Conclusions Among the platform workers in Seoul, age and oral examination were related factors for denture needs. To promote the oral health of platform workers, the policy to increase oral examination should be implemented.

Stroke is one of the leading causes of death and physical disability among adults. It has been 15 years since clinical trials of stem cell therapy in patients with stroke have been conducted using adult stem cells like mesenchymal stem cells and bone marrow mononuclear cells. Results of randomized controlled trials showed that adult stem cell therapy was safe but its efficacy was modest, underscoring the need for new stem cell therapy strategies. The primary limitations of current stem cell therapies include (a) the limited source of engraftable stem cells, (b) the presence of optimal time window for stem cell therapies, (c) inherited limitation of stem cells in terms of growth, trophic support, and differentiation potential, and (d) possible transplanted cell-mediated adverse effects, such as tumor formation. Here, we discuss recent advances that overcome these hurdles in adult stem cell therapy for stroke.
Adult Stem Cells* ; Adult* ; Biocompatible Materials ; Bone Marrow ; Cause of Death ; Humans ; Mesenchymal Stromal Cells ; Stem Cells ; Stroke*

PURPOSE: This study was done to identify predictors differentiating the preparation stage, which is the stage that the smoker is ready to quit smoking, between adolescent smokers and adult smokers. METHOD: A survey was conducted with 376 adolescent smokers in 4 high schools and 451 adult smokers in community settings in South Korea from August 2003 to April 2005. To identify the predictors before and after preparation in stages of change of smoking, logistic regression was done. RESULTS: The predictors for before preparation in stages of change of smoking were process of change for smoking abstinence for adolescent smokers and depression for adult smokers. The predictors for after preparation in stages of change of smoking were self-efficacy for smoking abstinence for adolescent smoker and self-efficacy for smoking abstinence and smoking temptation for adult smokers. CONCLUSION: For each group, adolescent smokers and adult smokers, specific smoking intervention methods need to be developed based on the different ways individuals make the decision to quit smoking within their contexts.
Adolescent* ; Adult* ; Depression ; Humans ; Korea ; Logistic Models ; Smoke* ; Smoking*

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/complications/*drug therapy ; Female ; Humans ; Intestinal Fistula/*chemically induced/complications/radiography/surgery ; Intestinal Perforation/*chemically induced/complications/radiography/surgery ; Protein Kinase Inhibitors/*adverse effects/therapeutic use ; Quinazolines/*adverse effects/therapeutic use ; Sigmoid Diseases/*chemically induced/complications/radiography/surgery

PURPOSE: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. METHODS: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. RESULTS: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. CONCLUSION: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.
Colon ; Communicable Diseases ; Delivery of Health Care ; Disease Transmission, Infectious ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Infection Control ; Patient Isolation

METHODS: The efficiency of electroporation-based delivery of AsCpf1/mRNA and AsCpf1/RNP to target exon 3 of leukemia inhibitory factor (Lif) into mouse zygotes was evaluated. Embryos that developed to the two-cell stage after zygote electroporation were transferred into the oviducts of surrogate mothers to produce AsCpf1-mediated LIF KO mice. The genome editing efficiency of blastocysts and pups was tested using the T7E1 assay and/or DNA sequencing. Congenital abnormalities and reproductive phenotypes in LIF KO mice produced by electroporation with AsCpf1/RNP were examined. RESULTS: Survival and two-cell development of electroporated zygotes were comparable between the AsCpf1/mRNA and AsCpf1/RNP groups, whereas genome editing efficiency was relatively higher in the AsCpf1/RNP group (13.3% vs 18.1% at blastocyst and 33.3% vs 45.5% at offspring), respectively. Two mouse lines with a frameshift mutation in exon 3 of the Lif gene were established from the AsCpf1/RNP group. All congenital abnormalities of LIF KO mice produced by AsCpf1/RNP electroporation were observed. AsCpf1-mediated LIF KO mice showed postnatal growth retardation and implantation failure, both of which are major phenotypes of LIF KO mice generated by conventional gene targeting. CONCLUSION Electroporation of AsCpf1/RNP at the zygote stage is an efficient genome editing method to produce KO mice.

METHODS: The efficiency of electroporation-based delivery of AsCpf1/mRNA and AsCpf1/RNP to target exon 3 of leukemia inhibitory factor (Lif) into mouse zygotes was evaluated. Embryos that developed to the two-cell stage after zygote electroporation were transferred into the oviducts of surrogate mothers to produce AsCpf1-mediated LIF KO mice. The genome editing efficiency of blastocysts and pups was tested using the T7E1 assay and/or DNA sequencing. Congenital abnormalities and reproductive phenotypes in LIF KO mice produced by electroporation with AsCpf1/RNP were examined. RESULTS: Survival and two-cell development of electroporated zygotes were comparable between the AsCpf1/mRNA and AsCpf1/RNP groups, whereas genome editing efficiency was relatively higher in the AsCpf1/RNP group (13.3% vs 18.1% at blastocyst and 33.3% vs 45.5% at offspring), respectively. Two mouse lines with a frameshift mutation in exon 3 of the Lif gene were established from the AsCpf1/RNP group. All congenital abnormalities of LIF KO mice produced by AsCpf1/RNP electroporation were observed. AsCpf1-mediated LIF KO mice showed postnatal growth retardation and implantation failure, both of which are major phenotypes of LIF KO mice generated by conventional gene targeting. CONCLUSION Electroporation of AsCpf1/RNP at the zygote stage is an efficient genome editing method to produce KO mice.

PURPOSE: Mycophenolic acid (MPA), a potent inhibitor of inosine-monophosphate dehydrogenase (IMPDH), was used as a new immunosuppressive drug since 1990s. It was reported that MPA increased neuronal survival after excitotoxic injury, induced apoptosis in microglial cells, inhibited the induction of inducible nitric oxide synthase (iNOS) in astrocytes. and inhibited microglial cell proliferation in N-methyl-D-aspartate (NMDA) induced hippocampal cells. However, the effects of MPA on the perinatal hypoxic-ischemic (HI) brain injury had not been yet evaluated. Therefore, we examined whether MPA could be neuroprotective in the HI brain injury. METHODS: Cortical cells were cultured using a 18-day-pregnant Sprague-Dawley (SD) rats and incubated in 1% O2 incubator for hypoxia. MPA (10 ug/mL) before or after a HI insult were treated. Seven-day-old SD rat pups were subjected to left carotid occlusion followed by 2.5 hours of hypoxic exposure (8% O2). MPA (10 mg/kg) were administrated intraperitoneally before or after a HI insult. Nitric oxide (NO) activity and expression of N-methyl-D-aspartate (NMDA) receptors also measured using Real-time PCR with primer pairs of isoforms of NOS; iNOS, endothelial NOS (eNOS), neuronal NOS (nNOS), and subunits of NMDA receptors; NR1, NR2A, NR2B, NR2C, NR2D. RESULTS: The expression of iNOS was decreased in the hypoxia group but increased in the MPA-treated group. However express or that eNOS and nNOS were inversed. The expression of all NMDA receptor subunits except NR2B was decreased in the hypoxia group but increased in the MPA-treated group. CONCLUSION: This study indicates that the administration of MPA before a HI insult could significantly protect against perinatal HI brain injury via some parts of NO-mediated or excitotoxic mechanisms.
Animals ; Anoxia ; Apoptosis ; Astrocytes ; Brain Injuries* ; Brain* ; Cell Proliferation ; Incubators ; Mycophenolic Acid* ; N-Methylaspartate* ; Neurons ; Nitric Oxide Synthase Type II ; Nitric Oxide Synthase* ; Nitric Oxide* ; Oxidoreductases ; Protein Isoforms* ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, N-Methyl-D-Aspartate

Background: and Purpose The natural course of adult-onset moyamoya disease (MMD) is unknown, and there is no medical treatment that halts its progression. We hypothesized that progressive shrinkage of large intracranial arteries occurs in adult-onset MMD, and that cilostazol inhibits this process. Methods: Serial high-resolution magnetic resonance imaging (HR-MRI) was performed on 66 patients with MMD: 30 patients received cilostazol, 21 received other antiplatelets, and 15 received no antiplatelets or had poor compliance to them. Serial HR-MRI was performed (interval between MRI scans: 29.67±18.02 months, mean±SD), and changes in outer diameter, luminal stenosis, and vascular enhancement were measured. Factors affecting HR-MRI changes were evaluated, including vascular risk factors and the ring finger protein 213 gene variant. Results: The progression of stenosis to occlusion, recurrent ischemic stroke, and the development of new stenotic segments were observed in seven, seven, and three patients, respectively. Serial HR-MRI indicated that the degree of stenosis increased with negative remodeling (outer diameter shrinkage). Patients who received cilostazol presented significantly larger outer diameters and lower degrees of stenosis compared with other groups (p=0.005 and p=0.031, respectively). After adjusting for clinical and genetic factors, only cilostazol use was independently associated with negative remodeling (odds ratio=0.29, 95% confidence interval=0.10–0.84, p=0.023). While vascular enhancement was observed in most patients (61 patients), the progression of enhancement or the occurrence of new vascular enhancement was rarely observed on follow-up HR-MRI (6 and 1 patients, respectively). Conclusions Adult-onset MMD induces progressive shrinkage of large intracranial arteries, which cilostazol treatment may prevent. Further randomized clinical trials are warranted.