PURPOSE: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. METHODS: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. RESULTS: There was a significant score difference in stress (t=-2.302, p<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, p<0.01; r=0, p<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, p<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, p<0.05). The emotional status of families were influenced by monthly income (F=4.036, p<0.05) and patients' diagnosis (F=3.088, p<0.05). CONCLUSION: These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.
Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Nursing ; Surveys and Questionnaires ; Seoul

PURPOSE: This study was to suggest the direction to the exercise intervention development for the stroke survivors. METHOD: 12 domestic and 54 foreign research papers about the exercise intervention for the stroke patients published during 1998~2007 were analyzed. RESULT: Among the papers, quasi-experimental design(75.8%) and multidisciplinary approach(60.6%) were the most frequent ones. The mean age of the respondents was 63.3 and the intervention was supplied for 7.14 weeks. The frequency of exercise was 3.87 per week and the exercise time was 1.88 hours. And physical research variables - such as ambulation, muscle strength, activities of daily living and balance - were more than psychosocial variables. This study suggested that the exercise intervention for the stroke survivors need to include aerobic exercise, muscle strengthening exercise, flexible exercise, body coordination, balance exercise. In addition we confirmed that the exercise intervention was revealed as an effective physiological parameters; such as maximum oxygen uptake quantity, blood pressure. CONCLUSION: We suggest that the further researchs are needed which include the intensity of exercise into the quantity of the exercise. Also researchers need to extend the motion intervention time for an effective sociopsychological variable and to try the meta analysis for the effective exercise intervention for the stroke survivors.
Activities of Daily Living ; Blood Pressure ; Surveys and Questionnaires ; Exercise ; Humans ; Muscle Strength ; Oxygen ; Stroke* ; Survivors* ; Walking

BACKGROUND: Coughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation. METHODS: In total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 microg/kg/hr (Group S1) or 0.3 microg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery. RESULTS: Groups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences. CONCLUSIONS: A sufentanil infusion (0.2-0.3 microg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.
Airway Extubation ; Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia Recovery Period ; Body Mass Index ; Cough ; Eye ; Hemodynamics ; Humans ; Hypertension ; Hysterectomy ; Incidence ; Isoflurane ; Laryngismus ; Nausea ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Skin ; Sufentanil ; Tachycardia ; Vomiting

BACKGROUND: Coughing, hypertension, tachycardia, and even laryngospasm can occur due to airway irritation during emergence from anesthesia. We investigated the effect of maintaining a sufentanil infusion during emergence from anesthesia by evaluating the incidence of cough and recovery profiles at extubation. METHODS: In total, eighty-four patients undergoing an elective laparoscopic hysterectomy were randomly divided into two sufentanil groups and a control group. During emergence, sufentanil was administered in the sufentanil groups at a rate of 0.2 microg/kg/hr (Group S1) or 0.3 microg/kg/hr (Group S2), and saline was administered to the control group. Cough score, hemodynamic changes, and recovery profiles, such as duration from skin closure to a bispectral index of 80, to eye opening at verbal command, to tracheal extubation and the total duration of study solution infusion, were recorded. The pain score, the total volume of administered patient-controlled analgesia (PCA), and the postoperative nausea and vomiting (PONV) score were evaluated 1, 6, and 24 hours after surgery. RESULTS: Groups S1 and S2 showed significantly lower cough scores and smaller hemodynamic changes on extubation compared to Group C. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were significantly lower in Groups S1 and S2 than in the control group. However, pain score, and PONV at 6 hours and 24 hours postoperatively showed no significant differences. CONCLUSIONS: A sufentanil infusion (0.2-0.3 microg/kg/hr) during emergence from desflurane anesthesia may suppress coughing on extubation in patients with body mass indexes (BMI) of 21-26 without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.
Airway Extubation ; Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia Recovery Period ; Body Mass Index ; Cough ; Eye ; Hemodynamics ; Humans ; Hypertension ; Hysterectomy ; Incidence ; Isoflurane ; Laryngismus ; Nausea ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Skin ; Sufentanil ; Tachycardia ; Vomiting

BACKGROUND: There is a recent trend of increased use of the gel test for the detection of unexpected antibodies (Abs) because of its simplicity and ease with which definitive interpretation can be made. However, because of the low insurance payments in Korea, only the LISS/Coombs card is used and thus the detection rate of the cold Abs has decreased. We have studied the detection rates of the Abs in patients by using the LISS/Coombs gel test and thus evaluated the clinical usefulness of the LISS/Coombs gel test. METHODS: Abs screening tests have been carried out using the DiaMed(TM) LISS/Coombs gel card test (Murten, Switzerland) on 14,942 patients for whom blood transfusions were ordered between July 1, 1997 and March 31, 2001. When the test for Abs was positive, Ab identification tests were further carried out with the DiaMed(TM) LISS/Coombs gel card and the ID-DiaPanel 1-11. RESULTS: Eighty-one out of 14,942 patients (0.54%) revealed positive results. Of these, 15 showed anti-E, 5 showed anti-E+c, 4 showed anti-C, 3 showed anti-D, 2 showed anti-Jk(a), 1 each showed anti-c, anti-M, anti-Lu(a), and anti-K Abs. CONCLUSIONS: Although the detection rate for the cold Abs of the LISS/Coombs gel test was low, it is considered to be highly useful because of the high detection rate for the clinically important warm Abs, the simplicity in carrying out the test, and the easy readability of test results.
Antibodies ; Blood Transfusion ; Comprehension ; Humans ; Insurance ; Korea ; Mass Screening

PURPOSE: The aim of this study was to design an intraoral environment simulator and to assess the accuracy of two intraoral scanners using the simulator. MATERIALS AND METHODS: A box-shaped intraoral environment simulator was designed to simulate two specific intraoral environments. The cast was scanned 10 times by Identica Blue (MEDIT, Seoul, South Korea), TRIOS (3Shape, Copenhagen, Denmark), and CS3500 (Carestream Dental, Georgia, USA) scanners in the two simulated groups. The distances between the left and right canines (D3), first molars (D6), second molars (D7), and the left canine and left second molar (D37) were measured. The distance data were analyzed by the Kruskal-Wallis test. RESULTS: The differences in intraoral environments were not statistically significant (P>.05). Between intraoral scanners, statistically significant differences (P < .05) were revealed by the Kruskal-Wallis test with regard to D3 and D6. CONCLUSION: No difference due to the intraoral environment was revealed. The simulator will contribute to the higher accuracy of intraoral scanners in the future.
Georgia ; Molar ; Seoul

BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.METHODS: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.RESULTS: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.CONCLUSION: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.
Body Mass Index ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Female ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Incidence ; Mass Screening ; Obesity ; Phenotype ; Weight Gain

BACKGROUND: The incidence of infections with imipenem- resistant Acinetobacter baumannii (IRAB) and Pseudomonas aeruginosa (IRPA) is increasing worldwide, and recent molecular studies indicate that the prevalence of carbapenemases is increasing in various parts of the world. However, few long-term longitudinal studies have assessed the prevalence of IRAB- and IRPA-derived carbapenemases and integrases in a hospital setting in Korea. METHODS: The carbapenemase genes (blaOXA-23, blaOXA-24, blaOXA-58, blaIMP-1, blaVIM-2, blaSIM-1, blaSPM-1) and integrase genes (intI1, intI2, intI3) produced by 46 IRAB strains and 51 IRPA strains collected at Chosun University Hospital between 2003 and 2006 were determined by PCR. RESULTS: The IRAB strains produced class 1 integrases more often than did the IRPA strains. However, the incidence increased steadily in both strains, reaching 100% in 2006. Carbapenemases of blaIMP-1 and blaVIM-2 types were found in 57% and 64% of the IRAB strains, respectively, in 2003. However, only one strain with blaVIM-2 was found in 2004 and another one with blaIMP-1 in 2005. The prevalence of carbapenemases was very low in the IRPA strains, just one strain with blaVIM-2 in 2005 and another one with blaoxa-23 in 2006. No other types of carbapenemase genes were detected in both strains. Rep-PCR of IRAB strains in 2003 showed different patterns. CONCLUSION: The incidence of carbapenemase varied by year but was generally low, except in 2003. The prevalence of class 1 integrases was consistently high and increased every year. The reason for the high prevalence of carbapenemases in 2003 is still unknown, but we assumed that it was not from the spread of a clone containing either blaIMP-1 or blaVIM-2 because the strains exhibited different rep-PCR patterns.
Acinetobacter baumannii* ; Acinetobacter* ; Clone Cells ; Imipenem ; Incidence ; Integrases* ; Korea ; Polymerase Chain Reaction ; Prevalence* ; Pseudomonas aeruginosa* ; Pseudomonas*

An endolichenic fungus Xylaria grammica EL000614 produces grammicin, a potent nematicidal pyrone derivative that can serve as a new control option for root-knot nematodes. We optimized an Agrobacterium tumefaciens-mediated transformation (ATMT) protocol for X.grammica to support genetic studies. Transformants were successfully generated after co-cultivation of homogenized young mycelia of X.grammica with A. tumefaciens strain AGL-1 carrying a binary vector that contains the bacterial hygromycin B phosphotransferase (hph) gene and the eGFP gene in T-DNA. The resulting transformants were mitotically stable, and PCR analysis showed the integratin of both genes in the genome of transformants.Expression of eGFP was confirmed via fluorescence microscopy. Southern analysis showed that 131 (78.9%) out of 166 transformants contained a single T-DNA insertion. Crucial factors for producing predominantly single T-DNA transformants include 48 h of co-cultivation, pretreatment of A. tumefaciens cells with acetosyringone before co-cultivation, and using freshly prepared mycelia. The established ATMT protocol offers an efficient tool for random insertional mutagenesis and gene transfer in studying the biology and ecology ofX.grammica.

Alcoholic liver cirrhosis (ALC) is caused by chronic alcohol overconsumption and might be linked to dysregulated immune responses in the gut-liver axis. However, there is a lack of comprehensive research on levels and functions of innate lymphocytes including mucosalassociated invariant T (MAIT) cells, NKT cells, and NK (NK) cells in ALC patients. Thus, the aim of this study was to examine the levels and function of these cells, evaluate their clinical relevance, and explore their immunologic roles in the pathogenesis of ALC. Peripheral blood samples from ALC patients (n = 31) and healthy controls (HCs, n = 31) were collected. MAIT cells, NKT cells, NK cells, cytokines, CD69, PD-1, and lymphocyte-activation gene 3 (LAG-3) levels were measured by flow cytometry. Percentages and numbers of circulating MAIT cells, NKT cells, and NK cells were significantly reduced in ALC patients than in HCs. MAIT cell exhibited increased production of IL-17 and expression levels of CD69, PD-1, and LAG-3. NKT cells displayed decreased production of IFN-γ and IL-4. NK cells showed elevated CD69 expression. Absolute MAIT cell levels were positively correlated with lymphocyte count but negatively correlated with C-reactive protein. In addition, NKT cell levels were negatively correlated with hemoglobin levels. Furthermore, log-transformed absolute MAIT cell levels were negatively correlated with the Age, Bilirubin, INR, and Creatinine score. This study demonstrates that circulating MAIT cells, NKT cells, and NK cells are numerically deficient in ALC patients, and the degree of cytokine production and activation status also changed. Besides, some of their deficiencies are related to several clinical parameters. These findings provide important information about immune responses of ALC patients.