Issues related to the elderly have been recognized in Korea and nursing scholars have tried to study there issues. It is hard to say which the direction we, are going or have to go, since there has been little systemic effort to establish gerontological nursing field yet. Therefore, it is necessary to find out the trend and the guidelines of gerontolotical nursing studies for the future. Dissertation and published articles related to the elderly in the nursing field from 1991 to the February of 1997 were are reviewed. Total 127 studies were analysed in terms of concept, design/methodology, and results, and the nature and issues of the geronotologic nursing studies in Korea were explored. The results are as follows: 1. There was no clear chronological definition of the elderly. 2. The most popular research design was an exploratory/descriptive study. 3. The major concepts studies were physical and mental health. 4. Among those studies using instrument which were developed and modified and /or translated by researchers, the reliability and validity were rarely reported. 5. Theory based studies were rare. We suggest the following issues for future studies : 1. The chronological and other criteria related to the definition of elderly is needed. 2. Physiopsychosocial characteristics of Korean elderly and their managements in terms of intervention studies need to be conducted more synthetically. 3. Social issues from the change of types and function of family such as single elderly family need to be studied. 4. Participation in and collaborate with other disciplines are needed. 5 Development and test of instruments to measure phenomena or concepts is needed. 6. Macroscopic approach such as policy also needed. 7. Theory based studies are needed.
Aged ; Humans ; Korea* ; Mental Health ; Nursing* ; Reproducibility of Results ; Research Design

PURPOSE: Regardless of premature rupture of membranes, the genital colonization of Ureaplasma urealyticum (Uu) in pregnant women could transmit vertical infections of their babies and cause neonatal infections, which ultimately result in infections in many other organs. The purpose of this study is to determine clinical influences on the infants born from mothers suffering genital Uu colonization. METHODS: We retrospectively reviewed the data for analysis of the 219 infants born from mothers who had been tested for genital Uu culture (about 470 cases) for past 3 years from Mar. 2006 to Jun. 2009, in East-West Neo Medical Center, Kyunghee University. The neonatal clinical manifestations such as duration of tachypnea, incidence of oxygen therapy, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), sepsis, jaundice, feeding intolerance, etc. were investigated during gestational period. RESULTS: In case of positive genital Uu culture of mothers, the preterm infants (gestational period <35 weeks) had symptoms of increased heart rate within 6 hours after birth, prolonged tachypnea, short period of antibiotics use, and lower incidence of RDS and hypocalcemia. Durations of oxygen therapy, the methods and durations of positive pressure ventilation and incidences of BPD of preterm infants were not affected by maternal Uu results. The near and full term infants (gestational period > or =35 weeks) from Uu positive mothers showed the increased incidence of jaundice. CONCLUSION: It is hard to say that genital Uu colonization in pregnant women influence the near and full term infants except jaundice. However, the data analysis of the preterm infants from Uu mothers demonstrated increased heart rate within 6 hours after birth, prolonged tachypnea, short period of antibiotics use, lower incidence of RDS and hypocalcemia.
Anti-Bacterial Agents ; Bronchopulmonary Dysplasia ; Colon ; Female ; Heart Rate ; Humans ; Hypocalcemia ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Jaundice ; Membranes ; Mothers ; Oxygen ; Parturition ; Positive-Pressure Respiration ; Pregnant Women ; Respiratory Therapy ; Retrospective Studies ; Rupture ; Sepsis ; Statistics as Topic ; Stress, Psychological ; Tachypnea ; Ureaplasma ; Ureaplasma urealyticum

BACKGROUND: Priming and boosting vaccination strategy has been widely explored for new vaccine development against tuberculosis. As an effort to identify other vaccine candidates, this study was initiated to evaluate protective efficacy of adenylate kinase (AK), nucleoside diphosphate kinase (NdK), and heat shock protein 70 (Hsp70) of Mycobacterium tuberculosis. METHOD: M. tuberculosis genes encoding AK, NdK, and Hsp70 proteins were amplified by PCR and cloned into E. coli expression vector, pQE30. Recombinant AK, NdK, and Hsp70 was purified through Ni-NTA resin. To evaluate immune responses, we performed enzyme-linked immunosorbent assay (ELISA) for IgG isotype and IFN-gamma after mice were immunized subcutaneously with recombinant proteins delivered in dimethyl dioctadecylammonium bromide (DDA). Immunized- and control groups were challenged by aerosol with M. tuberculosis. The spleens and lungs of mice were removed aseptically and cultured for CFU of M. tuberculosis. RESULT: Vaccination with recombinant proteins AK, NdK, and Hsp70 delivered in DDA elicited significant level of antibody and IFN-gamma responses to corresponding antigens but no protective immunity comparable to that achieved with Mycobacterium bovis BCG. CONCLUSION: Recombinant proteins AK, NdK, and Hsp70 do not effectively control growth of M. tuberculosis in mice when immunized with DDA as an adjuvant.
Adenylate Kinase* ; Animals ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Heat-Shock Proteins* ; HSP70 Heat-Shock Proteins* ; Immunoglobulin G ; Lung ; Mice* ; Mycobacterium bovis ; Mycobacterium tuberculosis* ; Mycobacterium* ; Nucleoside-Diphosphate Kinase* ; Polymerase Chain Reaction ; Recombinant Proteins* ; Spleen ; Tuberculosis ; Vaccination

Systemic lupus erythematosus frequently has thoracic involvement among connective tissue diseases. One of the pleuropulmonary manifestations is diffuse interstitial lung disease including nonspecific interstitial pneumonia(NSIP). NSIP if a newly classified disease among interstitial lung diseases. Systemic lupus erythematosus has a better prognosis than usual interstitial peumonia(UIP) and responds well to steroids. In this report, a 34 year-old woman who complained of a dry cough, and exertional dyspnea for 2 months is described. The chest X-ray showed fine reticular opacities and a mild honeycomb appearance in both basal lungs. High resolution computed tomography(HRCT) showed bilateral patchy areas of ground-glass attenuation and a mild honeycomb appearance in the subpleural of both the lower and the middle portion of the lung fields. An open lung biopsy showed prominent lymphocytic interstitial inflammation and fibrosis with small are as with a honeycomb appearance. This case was diagnosed as NSIP associated with systemic lupus erythematosus and was managed with oral steroids. Here we report a case of nonspecific interstitial pneumonia associated with systemic lupus erythematosus confirmed by HRCT and an open lung biopsy with a review of the relevant literature.
Biopsy ; Connective Tissue Diseases ; Cough ; Dyspnea ; Female ; Fibrosis ; Humans ; Inflammation ; Lung ; Lung Diseases, Interstitial* ; Lupus Erythematosus, Systemic* ; Prognosis ; Steroids ; Thorax

Although heparin has over the years proven to be a reliable anticoagulant, there are still several undesirable side effects including dyslipidemia. Several recent publications have suggested that a low-molecular-weight heparin(LMWH) is superior to conventional heparin because it causes less side effects and has beneficial effects on lipid parameters. But the results of the study about lipid parameters are controversial. We conducted a prospective study to evaluate the efficacy, safetey and effect of LMWH on lipid parameters as an anticoagulant in hemodialysis therapy. 2500 a x a IU of LMWH(Fragmin ) were given to 51 maintenance hemodialysis patients (age:49.9+/-16.1, M:F=33:18) just before each dialysis for consecutive 12 hemodialysis. And 16 patients out of 51 patients were given for 6 months to compare the changes of lipid parameters with those in 22 patients with conventional heparin. The mean venous compression time and the degree of clot deposition in dialyzer were similar in both LMWH and conventional heparin group. The heparin concentration via anti-factor Xa-specific clotting method (Heptest ) in both groups was similar(0.64+/-0.24 vs 0.54+/-0.18IU/ml at 15 min, 0.32+/-0.13 vs. 0.26+/-0.24 IU/ml at 4 hours after starting hemodialysis). The hematologic parameters such as hemoglobin and platelet count level did not show any differences between the two types of heparin. The level of triglyceride was significantly decreased after 6 month by the LMWH therapy(177.6+/-60.9 vs 145.9+/-85.5mg/dl, P<0.05) but was not changed by the conventional heparin therapy(150.6+/-54.6 vs. 176.6+/-64.6, P=0.16). The level of HDL were significantly changed in both group(32.1+/-11.6 vs. 37.9+/-9.7mg/dl, P<0.05 in LMWH group , 40.4+/-11.9 vs. 33.7+/-7.8mg/dl, P<0.05 in conventional heparin group). The levels of total cholesterol and LDL-cholesterol were decreased in LMWH group but statistically insignificant. We conclude that LMWH is a suitable alternative to unfractionated conventional heparin for anticoagulation therapy and has beneficial effects on the lipoprotein profile in hemodialysis patients.
Cholesterol ; Dalteparin ; Dialysis ; Dyslipidemias ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Lipoproteins ; Platelet Count ; Prospective Studies ; Renal Dialysis* ; Triglycerides

Bovine tuberculosis (TB) is a major zoonosis that's caused by Mycobacterium bovis (M. bovis). Being able to detect M. bovis is important to control bovine TB. We applied a molecular technique, the variable number tandem repeat (VNTR) typing method, to identify and distinguish the M. bovis isolates from Gyeonggi-do, Korea. From 2003 to 2004, 59 M. bovis clinical strains were isolated from dairy cattle in Gyeonggi-do, Korea, and these cattle had tuberculosis-like lesions. Twenty-four published MIRUVNTR markers were applied to the M. bovis isolates and ten of them showed allelic diversity. The most discriminatory locus for the M. bovis isolates in Korea was QUB 3336 (h = 0.64). QUB 26 and MIRU 31 also showed high discriminative power (h = 0.35). The allelic diversity by the combination of all VNTR loci was 0.86. Six loci (MIRU 31, ETR-A and QUB-18, -26, -3232, -3336) displayed valuable allelic diversity. Twelve genotypes were identified from the 59 M. bovis isolates that originated from 20 cattle farms that were dispersed throughout the region of Gyenggi-do. Two genotypes [designation index (d.i.) = e, g] showed the highest prevalence (20% of the total farms). For the multiple outbreaks on three farms, two successive outbreaks were caused by the same genotype at two farms. Interestingly, the third outbreak at one farm was caused by both a new genotype and a previous genotype. In conclusion, this study suggests that MIRU-VNTR typing is useful to identify and distinguish the M. bovis isolates from Gyeonggi-do, Korea.
Animals ; Cattle ; DNA Primers/genetics ; *Genetic Variation ; Genotype ; Korea/epidemiology ; Minisatellite Repeats/*genetics ; Mycobacterium bovis/*genetics ; Prevalence ; Tuberculosis, Bovine/*epidemiology/*microbiology

High concentrations of ATP induce membrane blebbing. However, the underlying mechanism involved in epithelial cells remains unclear. In this study, we investigated the role of the P2X7 receptor (P2X7R) in membrane blebbing using Par C5 cells. We stimulated the cells with 5 mM of ATP for 1~2 hrs and found the characteristics of membrane blebbing, a hallmark of apoptotic cell death. In addition, 500 micrometer Bz-ATP, a specific P2X7R agonist, induced membrane blebbing. However, 300 micrometer of Ox-ATP, a P2X7R antagonist, inhibited ATP-induced membrane blebbing, suggesting that ATP-induced membrane blebbing is mediated by P2X7R. We found that ATP-induced membrane blebbing was mediated by ROCK I activation and MLC phosphorylation, but not by caspase-3. Five mM of ATP evoked a biphasic [Ca2+]i response; a transient [Ca2+]i peak and sustained [Ca2+]i increase secondary to ATP-stimulated Ca2+ influx. These results suggest that P2X7R plays a role in membrane blebbing of the salivary gland epithelial cells.
Adenosine Triphosphate ; Blister ; Caspase 3 ; Cell Death ; Epithelial Cells ; Membranes ; Phosphorylation ; Receptors, Purinergic P2X7 ; Salivary Glands

A bronchobiliary fistula (BBF), which is defined by an abnormal communication between the biliary system and the bronchial tree, is an uncommon complication after hemihepatectomy, trauma, hydatid disease, choledocholithiasis, and other causes of biliary obstruction. BBF are rare complication of hepatic resection that can present from days to years after operation. Management of fistula is often very difficult and can be associated with high morbidity and mortality rates. Early recognition and proper management are essential to avoid a fatal outcome. Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) are the diagnostic studies of choice and offer the possibility of therapeutic intervention. Although large series in the literature emphasize the surgical management of BBF, the reoperative procedures tend to be complicated, with a significant morbidity and mortality. Nonsurgical intervention via ERCP or PTC are more recently notably successful when resolution of a distal biliary obstruction is accomplished. Only after aggressive attempts at nonoperative, interventional techniques have failed should operative approaches be entertained. We are reporting a case of BBF secondary to hepatic resection of hepatocellular carcinoma which was managed by surgical operation.
Biliary Tract ; Carcinoma, Hepatocellular ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Fatal Outcome ; Fistula* ; Hepatectomy ; Mortality

OBJECTIVES: This study was conducted to assess the concentration of urine cadmium and health risks of residents in the vicinity of abandoned metal mines in Gyeongsangbuk-do. METHODS: The concentration of cadmium in the soil, water, and agricultural crops was measured in Gyeongsangbuk-do, Butdeun and Suksan, which have abandoned metal mines. We measured the concentration of cadmium in the urine of residents from the following areas: 78 from village A, 99 from village C and 147 from control areas. Other health-risk assessments were performed on each resident, such as measuring the concentration of beta2-MG and a bone density test. RESULTS: In abandoned mine areas, the mean concentration of cadmium was higher in agricultural soil and in the crops than in that of control areas. The concentration of cadmium in the stream exceeded the guideline level. In regard to provisional tolerable daily intake (PTDI) of cadmium, the actual intake rate through crops was 33.81%, 72.74% in abandoned mine areas and 5.03%, 6.16% in control areas. Residents in abandoned mine areas, A village and C village had a geometric mean of urine Cd of 1.90 microgram/g cr and 1.45 microgram/g cr. These measurements were significantly higher than those of residents in control areas, B village and D village, 0.59 microgram/g cr and 0.65 microgram/g cr (p<0.01). Following adjustments for age, sex, smoking habit, and occupational history, the concentration of urine cadmium of residents in the Butdeun abandoned meta mine was higher by 1.62 microgram/g cr as compared with the control group (p<0.01). Residents from the Suksan abandoned metal mine also had a higher concentration by 1.07 microgram/g cr (p<0.01). A multiple linear regression analysis was performed for the factors associated with T-score, and this showed that the concentration of urine cadmium was not an influential factor. CONCLUSIONS: Based on these measurements, areas with abandoned metal mines contaminated streams, agricultural soil, and crops of the adjacent areas, with cadmium. Because residents in the adjacent areas intake contaminated crops, their urine cadmium was increased. Despite a lack of evidence demonstrating the detrimental effect of increased urine cadmium in residents, an additional study is needed to assess the health risks of residents in the vicinity of abandoned metal mines.
Bone Density ; Cadmium ; Crops, Agricultural ; Korea ; Linear Models ; Rivers ; Smoke ; Smoking ; Soil ; Water

OBJECTIVE: The aim of this study is to determine effects of nefazodone on depression, anxiety, sleep and sexual function in depressive patients. SUBJECTS AND METHODS: This is an open, non-comparative, multi-center study. Antidepressant and other clinical effects of nefazodone were evaluated in 230 patients of 26 centers, aged 14 years or more, who met DSM-IV criteria to major depressive disorder or dysthymic disorder and didn't have other psychiatric disorders and were physically healthy. The clinical efficacy was assessed at week 1, 2, 4 and 8 using Clinical Global Improvement (CGI), Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory-State Anxiety (STAI-SA). Other clinical effects were assessed with Weekly Sleep Questionnaire, Sexual Functioning Questionnaire and GHQ-QOL-12, a scale for quality of life. Adverse drug reactions were checked with a questionnaire. Post-treatment effects of drug were compared with pre-treatment baseline condition. RESULTS: The response rates by Clincal Grobal Improvement and HAM-D after 8 weeks treatment were 62.4% and 75.2% respectively. Comparing to baseline, nefazodone was proved to have significantly higher antidepressant and antianxiety effects in depressive patients and it improved also sleep, sexual functions and quality of life. Both patients and physicians satisfied with the effects of drug. Adverse drug reactions were a few and not serious, and most of them disappeared as treatment continued. CONCLUSION: These results suggest that not only nefazodone has antidepressant effects and antianxiety effects, but also it improves sleep disturbance, sexual dysfunction and the quality of life in depressive patients. Adverse drug reactions were a few and not serious.
Anti-Anxiety Agents ; Anxiety* ; Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Drug-Related Side Effects and Adverse Reactions ; Dysthymic Disorder ; Humans ; Quality of Life* ; Surveys and Questionnaires