PURPOSE: The purpose of this study was to investigate nurses' awareness of psychological distress and delirium in cancer patients and job stress. METHODS: The participants were 256 nurses in a cancer general hospital. The nurses' awareness of psychological distress and delirium was investigated using a self-report questionnaire (1–4 scale) developed by the researcher. Psychological distress was measured by depression, anxiety, and insomnia. Job stress was measured using the Korean version of the Expanded Nursing Stress Scale (1–4 scale). RESULTS: The analysis of 9 questionnaires about nurses' awareness was divided into two factors: nurses' competence and importance. Nurses' competence results were 2.06 (depression), 2.17 (anxiety), 2.29 (insomnia), and 2.41 (delirium). Importance results were 3.23 (depression), 3.20 (anxiety), 3.15 (insomnia), and 3.37 (delirium). Most nurses have experienced nursing psychological distress and delirium in cancer patients, but only about a quarter have received the relevant education. Job stress was 2.52 and in subcategories, work load received the highest score 2.92. CONCLUSION: Nurses recognize that psychological distress and delirium in cancer patients are very important, but they are less aware of their competence. Therefore, it is suggested to develop an educational program to improve nurses' competence when dealing with psychological distress and delirium.
Anxiety ; Delirium* ; Depression ; Education ; Hospitals, General ; Humans ; Mental Competency ; Nursing ; Sleep Initiation and Maintenance Disorders

PURPOSE: Maspin is a tumor suppressor protein that has been reported to stimulate the cell death of cancer and inhibit the metastasis of cancer. The present study aimed to explore the survival pathway by which maspin modulates the resistance of human lung cancer cells to chemotherapeutic drugs, and the consequences of maspin gene therapy in an animal model. MATERIALS AND METHODS: NCI-H157 and A549 cells were transfected with either a mock vector (pCMVTaq4C), maspin (pCMV-maspin), siControl or siMaspin. RT-PCR and Western blot analysis were performed to study the expressions of survival proteins in lung cancer. cDNA microarray analysis was carried out to compare the maspin-modulated gene expression between the xenograft tumors derived from the lung cancer cells that were stably transfected with pCMVTaq4C or pCMV-maspin. Maspin gene therapy was performed by intra-tumoral injections of pCMVTaq4C or pCMV-maspin into the pre-established subcutaneous tumors in nude mice. RESULTS: Maspin significantly decreased the survival to doxorubicin and etoposide, whereas did not affect the survival to cisplatin in the NCI-H157 cells. Interestingly, transfection with a maspin plasmid resulted in a significant reduction of the phosphorylation of Akt in the NCI-H157 cells, whereas knockdown of maspin increased the phosphorylation of Akt in the A549 cells. Microarray analysis of the xenograft tumors revealed a specific gene expression profile, demonstrating that maspin is associated with the differential expressions of PTEN and IGF2R. Direct transfer of pCMV-maspin into the tumor significantly retarded the tumor growth in the animal experiments (p=0.0048). CONCLUSION: Lung cancer cells lacking maspin could be resistant to chemotherapeutic drugs such as doxorubicin or etoposide, at least in part by maintaining Akt phosphorylation.
Animal Experimentation ; Animals ; Blotting, Western ; Cell Death ; Cisplatin ; Doxorubicin ; Etoposide ; Gene Expression ; Genetic Therapy ; Humans ; Lung ; Lung Neoplasms ; Mice ; Mice, Nude ; Microarray Analysis ; Models, Animal ; Neoplasm Metastasis ; Oligonucleotide Array Sequence Analysis ; Phosphorylation ; Plasmids ; Proteins ; Serpins ; Transcriptome ; Transfection ; Transplantation, Heterologous

PURPOSE: The purpose of this study was to identify the factors that affect nursing students' perception of pediatric safety nursing activities for children during hospitalization. METHODS: The study sample included 304 nursing students who had participated in pediatric nursing practice. Data were analyzed using SAS 9.3 program. RESULTS: Regression analysis showed that the model's explanatory power was 37%. Safety policy and procedure, safety priority, disaster experience, and knowing a place of refuge were factors affecting the perception of safety nursing activities for children during hospitalization. CONCLUSION: Findings show that safety policy and procedures and safety priority are major factors that affect the perception of safety nursing activities and indicate that effective education programs on safety policy and procedure and safety priority are necessary to improve the perception of safety nursing activities.
Child ; Child, Hospitalized ; Disasters ; Education ; Hospitalization ; Humans ; Nursing* ; Patient Safety* ; Pediatric Nursing ; Safety Management ; Students, Nursing

PUROPOSE: Surgical critically ill patients require adequate nutrition support and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) guidelines recommend low non-protein calorie:nitrogen ratio (NPC:N ratio, 70~100) for critically ill pateints. In this study, we assess the current use of early parenteral nutrition of surgical critically ill patients and analyze the clinical significance of NPC:N. METHODS: This is a retrospective study of critically ill adult patients who remained in the intensive care unit (ICU) for over 3 days and could not receive enteral nutrition for the first 7 days. Data on parenteral intake of patients were collected from electronic medical records. Association of NPC:N scores with clinical outcome (length of ICU stay, length; of hospital stay, duration of ventilation, and mortality) were analyzed using Pearson correlation and multiple regression. RESULTS: The study included 72 cases, average parenteral calorie intake was 14.6 kcal/kg/day and protein intake was 0.5 g/kg/day. We assessed the NPC:N scores to determine the patients' NPC:N for the first 7 days in ICU close to the A.S.P.E.N guidelines. NPC:N scores showed weak negative correlation with length of hospital stay and duration of mechanical ventilation (r=-0.259, P=0.028; r=-0.495, P=0.001). Multiple regression adjusted with APACHE (Acute Physiology and Chronic Health Evaluation) II score, age, and body mass index showed correlation of higher NPC:N score with decreased length of hospital stay and shorter duration of ventilation (P=0.0001, P=0.035, respectively). However, length of ICU stay and mortality within 60 days showed no significant correlation with NPC:N scores. CONCLUSION: Parenteral calories and protein intakes of critically ill patients in ICU were lower in comparison to A.S.P.E.N. recommendation in this study. Low NPC:N scores might be related to shorter length of hospital stay, duration of mechanical ventilation. Consultation of a nutritional support team could have a positive effect in providing appropriate nutrition support.
Adult ; APACHE ; Body Mass Index ; Critical Illness* ; Electronic Health Records ; Enteral Nutrition ; Humans ; Intensive Care Units ; Length of Stay ; Mortality ; Nitrogen* ; Nutritional Support ; Parenteral Nutrition* ; Physiology ; Protein-Energy Malnutrition ; Respiration, Artificial ; Retrospective Studies ; Ventilation

Pancreatic cancer is one of the most fatal cancers with a poor prognosis. Standard chemotherapies have proven largely ineffective because of their toxicity and the development of resistance. Therefore, there is an urgent need to develop novel therapies. In this study, we investigated the antitumor activity of MS-5, a naphthalene derivative, on BxPC-3, a human pancreatic cancer cell line. We observed that MS-5 was cytotoxic to BxPC-3 cells, as well as inhibited the growth of cells in a concentration- and time- dependent manner. Flow cytometry analysis revealed that the percentage of annexin V-positive cells increased after MS-5 treatment. We also observed cleavage of caspases and poly (ADP-ribose) polymerase, and downregulation of Bcl-xL protein. Flow cytometry analysis of intracellular levels of reactive oxygen species (ROS) and mitochondrial superoxide suggested that MS-5 induced the generation of mitochondrial superoxide while lowering the overall intracellular ROS levels. Thus, MS-5 may be potential candidate for pancreatic cancer treatment.

In this study, the marker compounds of Curcumae Rhizoma (CR) were simultaneously quantified by high-performance liquid chromatography equipped with a photodiode array detector and the anti-inflammatory effects of CR extract and marker compounds in human benign prostatic hyperplasia epithelial-1 (BPH-1) cell lines were investigated. The marker components (4S,5S)-(+)-germacrone-4,5-epoxide, furanodienone, and germacrone, were separated on Gemini C₁₈ columns (250 mm × 4.6 mm, 5 µm) at 40 ℃ by using a gradient of two mobile phases eluting at 1.0 mL/min. Prostaglandin E₂ (PGE₂) levels in Human BPH-1 cells were determined with an ELISA kit. The coefficients of determination in a calibration curve of each analyte were all 0.9997. The limits of detection and quantification of the three compounds were 0.10 – 0.32 µg/mL and 0.30 – 0.98 µg/mL, respectively. The content of three compounds, (4S,5S)-(+)-germacrone-4,5-epoxide, furanodienone, and germacrone, in the CR sample were found to be 5.79 – 5.92 mg/g, 4.72 – 4.86 mg/g, and 1.06 – 1.09 mg/g, respectively. Regarding pharmacological activity against benign prostatic hyperplasia, CR and its components significantly suppressed PGE₂ levels of BPH-1 cells. The established analysis method will help to improve quality assessment of CR samples and related products. In addition, CR and its components exhibit anti-inflammatory activity in BPH-1 cells, suggesting the inhibitory efficacy of these compounds against the pathogenesis of BPH.
Calibration ; Cell Line ; Chromatography, Liquid ; Curcuma ; Enzyme-Linked Immunosorbent Assay ; Humans ; Limit of Detection ; Methods ; Prostatic Hyperplasia ; Rhizome

BACKGROUND: Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention. MATERIALS AND METHODS: Data were retrospectively collected by reviewing electronic medical records. All hospitalized patients aged 18 and older who met the study inclusion criteria for the conversion were included between August and November 2015. We computed the physicians’ adherence rate to the ASP recommendations. We also measured the total use of fluoroquinolones, length of hospital stay, and medication costs. RESULTS: During 4 months, 129 cases were enrolled in the study. The adherence rate was 79.8%. The average total prescription volume of intravenous fluoroquinolones, the length of hospital stay, and the total cost of the fluoroquinolones statistically significantly decreased in the intervention-adherent group. CONCLUSION: Intervention to facilitate conversion from intravenous to oral administration has reduced excess use of intravenous fluoroquinolones and length of hospital stay. With these findings, further implementations of the ASP extending to other antibiotics may be warranted.
Administration, Oral ; Anti-Bacterial Agents ; Catheter-Related Infections ; Electronic Health Records ; Fluoroquinolones* ; Humans ; Length of Stay ; Prescriptions ; Retrospective Studies ; Viperidae

Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26- 3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.