PURPOSE: This research is to understand the effects of senior simulation on employees of elderly care facilities and utilize it in their job training. METHODS: This research is a nonequivalence control group pre-to-post quasiexperiment research. 18 employees who have experienced senior simulation are set as test group and 18 other employees who have not experienced senior simulation are set as control group. RESULTS: The hypothesis that 'the test group which has experienced senior simulation will show a positive change in their attitude on elderly care, compared to the control group' and 'the test group which has experienced senior simulation will show a positive change in understanding of elders, compared to the control group' was supported. The hypothesis that 'the test group which has experienced senior simulation will show a positive change in job satisfaction and performance of duties, compared to the control group' was dismissed. CONCLUSION: The senior simulation seems to contribute to elderly care facilities employees' change in their viewpoints of elders and broaden their understanding of them. The senior simulation was meaningful to provide basic help with implementing job training programs.
Aged ; Humans ; Job Satisfaction ; Nursing Homes

PURPOSE: This study is to verify the correlations between xerostomia, oral health quality of life, and knowledge about water intake among community-dwelling older adults and to suggest basic data for the development of oral health enhancement programs to improve the quality of life in the elderly. METHODS: A convenience sample of 112 elders was recruited in W city, Gangwon-do from July to August 2017. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation coefficients with SPSS/WIN 23.0 Program. RESULTS: The mean age of the subjects was 73 years old. As the score of knowledge about water intake was average 3 point (out of ten), the knowledge about physical symptoms in case of water deficiency was very insufficient. Xerostomia showed negative correlations with the oral health quality of life (r=−.379, p < .001) and knowledge about water intake (r=−.228, p < .016). CONCLUSION: For the relief of xerostomia having effects on the oral health quality of life in the elderly, it would be necessary to develop and apply oral health enhancement programs including the recommendation of water intake, and then to verify the effects.
Adult* ; Aged ; Drinking* ; Gangwon-do ; Humans ; Oral Health* ; Quality of Life* ; Water* ; Xerostomia*

PURPOSE: Renal vascular clamping during a laparoscopic partial nephrectomy is a time-consuming procedure with a risk of renal ischemia. To study the feasibility of laparoscopic partial nephrectomy without renal arterial clamping, we compared the procedure with laparoscopic partial nephrectomy with vascular clamping. MATERIALS AND METHODS: Seventeen patients underwent laparoscopic partial nephrectomy without renal arterial clamping (group 1) from February 2004 to June 2008. The operative results were reviewed retrospectively and compared with those of 16 patients who underwent laparoscopic partial nephrectomy with arterial clamping (group 2). Patient characteristics did not differ significantly between the 2 groups. However, exophytic tumors were detected in 13 patients in group 1 and 3 patients in group 2 (p=0.001). Scores on the preoperative aspects and dimensions used for an anatomical (PADUA) classification were 6.9 in group 1 and 7.7 in group 2 (p=0.037). All surgeries by the transperitoneal approach were performed by a single surgeon. RESULTS: The mean operative times were 103 and 130 minutes in groups 1 and 2, respectively (p=0.312). The mean renal arterial clamping time of group 2 was 27.6 minutes (range, 20-42 minutes). The mean estimated blood loss was 327 ml in group 1 and 315 ml in group 2 (p=0.971). The mean postoperative change in the glomerular filtration rate was 20.11 ml/min/1.73 m2 in group 1 and 18.95 ml/min/1.73 m2 in group 2 (p=0.748). The mean times to postoperative initiation of ambulation and of oral intake were 1.6 and 1.7 days (p=0.486) and 1.3 and 1.6 days (p=0.811) in groups 1 and 2, respectively. The mean length of hospital stay was 7.4 and 7.9 days in groups 1 and 2, respectively (p=0.9). The mean tumor size was 2.1 cm (range, 1-7 cm) in group 1 and 3.3 cm (range, 1.5-9 cm) in group 2. CONCLUSIONS: Laparoscopic partial nephrectomy without renal arterial clamping is feasible for a localized renal tumor. However, patients should be selected carefully, such as those with an exophytic tumor.
Constriction ; Glomerular Filtration Rate ; Humans ; Ischemia ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Nephrectomy ; Operative Time ; Retrospective Studies ; Walking

PURPOSE: The purpose of this study was to investigate the effects of emotional labor, emotional intelligence and social support on job stress in clinical nurses. METHODS: Participants were 123 clinical nurses and data were collected from October to December, 2011 and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with SPSS 18.0. RESULTS: A positive correlation was found between job stress and emotional labor. Emotional labor showed a significant negative correlation with emotional intelligence and social support, whereas a positive correlation was found between emotional intelligence and social support. The strongest predictor of job stress was emotional labor. In addition, institution satisfaction (dissatisfaction) and the reason for selecting the job (opportunities for service) accounted for 21% of variance in job stress. CONCLUSION: The results of this study suggest that it is important to manage emotional labor as well as to improve job satisfaction in order to reduce job stress in clinical nurses.
Emotional Intelligence ; Job Satisfaction

A majority of human lung cancer cell lines have developed resistance to growth inhibition via the activation of transforming growth facter-beta (TGF-beta). Previous studies have reported that growth inhibition of TGF-beta is linked to the expression of transforming growth factor-beta receptor type I (TGF-betaRI). Immunohistochemical studies of TGF-beta1 and TGF-betaRI have been carried out in 43 cases of lung neoplasm; including 25 cases of squamous cell carcinoma, 13 cases of adenocarcinoma, 2 cases of adenosquamous cell carcinoma, and 1 case each of undifferentiated carcinoma, small cell carcinoma and neuroendocrine carcinoma. Reverse transcriptase polymerase chain reaction (RT-PCR) for TGF-beta1 mRNA was also performed in 40 cases of tumors and 14 control cases of normal parenchyme. Immunohistochemically, TGF-beta1 and TGF-betaRI expression were noted in the cytoplasm of all type of tumor cells. The staining intensity and areas were examined and scored from 0 to 5. As a whole, TGF-beta1 staining scores in the neoplastic lesions were higher than that of the adjacent normal parenchyme, bronchial epithelium or alveolar epithelium. However, TGF-betaRI staining scores were generally lower than that of the adjacent normal components. The TGF-beta1 mRNA showed a higher percentage of expression in tumors than in normal control. Tumor size, lymph node metastasis, histological differentiation and histological type of tumors did not correlated with the staining score of TGF-beta1 and TGF-betaRI. These results indicate that although various types of human lung carcinoma cells produce TGF-beta1, they show a reduction in TGF-betaRI, resulting in an escape from growth inhibition by TGF-beta1.
Adenocarcinoma ; Carcinoma ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cell Line ; Cytoplasm ; Epithelium ; Humans* ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Transforming Growth Factor beta* ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; United Nations

PURPOSE: The objective of this study was to assess attenuation correction algorithms with the 137Cs point source for the brain positron emission tomography (PET) imaging process. MATERIALS AND METHODS: Four different types of phantoms were used in this study for testing various types of the attenuation correction techniques. Transmission data of a 137Cs point source were acquired after infusing the emission source into phantoms and then the emission data were subsequently acquired in 3D acquisition mode. Scatter corrections were performed with a background tail-fitting algorithm. Emission data were then reconstructed using iterative reconstruction method with a measured (MAC), elliptical (ELAC), segmented (SAC) and remapping (RAC) attenuation correction, respectively. Reconstructed images were then both qualitatively and quantitatively assessed. In addition, reconstructed images of a normal subject were assessed by nuclear medicine physicians. Subtracted images were also compared. RESULTS: ELAC, SAC, and RAC provided a uniform phantom image with less noise for a cylindrical phantom. In contrast, a decrease in intensity at the central portion of the attenuation map was noticed at the result of the MAC. Reconstructed images of Jaszack and Hoffan phantoms presented better quality with RAC and SAC. The attenuation of a skull on images of the normal subject was clearly noticed and the attenuation correction without considering the attenuation of the skull resulted in artificial defects on images of the brain. CONCLUSION: the complicated and improved attenuation correction methods were needed to obtain the better accuracy of the quantitative brain PET images.
Brain ; Noise ; Nuclear Medicine ; Positron-Emission Tomography ; Skull

Elevated peak inspiratory airway pressure (PIP) can occur during general anesthesia and is usually easily rectified. In rare circumstances it can lead to potentially fatal conditions such as tension pneumothorax. We report on a 77-year-old male patient admitted for a cervical laminoplasty. The preoperative chest radiograph showed normal findings and there was no medical history of allergy or underlying airway inflammation. Anesthesia induction and maintenance progressed uneventfully. However, 5 minutes after prophylactic antibiotic administration, PIP suddenly increased and blood pressure dropped. The operation was abandoned and the patient was moved to a supine position to perform chest radiography. Cardiac arrest occurred, and cardiopulmonary resuscitation was performed. The radiograph showed bilateral tension pneumothorax. Needle aspiration was immediately performed, and chest tubes were inserted. Ventilation rapidly improved and the vital signs normalized. The patient was discharged without sequelae on postoperative day 36.
Aged ; Anaphylaxis ; Anesthesia ; Anesthesia, General ; Blood Pressure ; Cardiopulmonary Resuscitation ; Chest Tubes ; Heart Arrest ; Humans ; Hypersensitivity ; Inflammation ; Male ; Needles ; Pneumothorax ; Spine ; Supine Position ; Thorax ; Ventilation ; Vital Signs

Experiments and simulation were done to study the impact of contrast agent when CT scan was used to attenuation correction for PET images in PET/CT system. Whole body phantom was imaged with various concentration of iodine-based contrast agent using CT. Mathematical emission and transmission density map with liver were made to simulate for whole body FDG imaging. A variety of factors were estimated, including non-uniform enhancement of contrast agent, concentration and distribution size of contrast agent, noise level, image resolution, reconstruction algorithm, hypo-attenuation of contrast agent, and different time phases for contrast agent. Experimental studies showed that Hounsfield unit depends on the concentration of contrast agent and tube voltage. From the simulation data, contrast agents introduced artifacts and degraded image quality on the attenuation-corrected PET images. The severity of these effects depends on a variety of factors, including the concentration and distribution size of contrast agent, the noise levels, and the image resolution. These results indicated that the impact of contrast agents should be considered with a full understanding of their potential problems in clinical PET/CT images.
Artifacts ; Contrast Media ; Liver ; Noise ; Positron-Emission Tomography and Computed Tomography ; Tomography, X-Ray Computed

PURPOSE: To determine whether topical tacrolimus might prove effective in the treatment of refractory anterior segment inflammatory diseases, and to evaluate its efficacy in eyes with ocular graft versus host disease (GVHD), and vernal keratoconjunctivitis (VKC). METHODS: Twenty-eight eyes of 14 patients with anterior segment inflammation refractory to steroid treatment were treated with 0.03% tacrolimus ointment at the Samsung Medical Center, Seoul, Korea from March 2008 through August 2009. Seven patients had ocular GVHD and seven had VKC. We evaluated the conjunctival and corneal inflammatory change at one, two, four, and eight weeks after treatment with a scoring system. Time to initial response of treatment and therapeutic effect between GVHD and VKC was also analyzed. After the eight-week treatment period, patients were divided into two groups (maintenance group and discontinuance group). Eight patients maintained the treatment for an additional four months, and six patients discontinued the treatments. Therapeutic effect was also compared between the groups at eight weeks and six months after treatment. RESULTS: The mean conjunctival and corneal inflammation score was reduced significantly at eight weeks after treatment (p < 0.0001). The therapeutic effect in conjunctival inflammation was first noted at week two after the initial treatment (p = 0.002); reduction in corneal inflammation was first noted at one week (p = 0.0009). When compared according to diagnosis, no therapeutic difference was detected between the groups (p > 0.05). Six months after treatment, we noted no therapeutic differences between the maintenance group and discontinuance group (p > 0.05). CONCLUSIONS: 0.03% tacrolimus ointment was safe and effective for use in anterior segment inflammatory disease refractory to steroid.
Administration, Topical ; Adolescent ; Adult ; Child ; Conjunctivitis, Allergic/*drug therapy ; Female ; *Graft vs Host Disease ; Humans ; Immunosuppressive Agents/*administration & dosage ; Male ; Middle Aged ; Ointments ; Prospective Studies ; Statistics, Nonparametric ; Tacrolimus/*administration & dosage ; Treatment Outcome

BACKGROUND AND OBJECTIVES: The BRAFV600E mutation has been regarded as the leading cause of papillary thyroid cancer (PTC). However, the multi-step carcinogenic process induced by BRAFV600E has been remained to be elucidated in thyroid gland. In this study, to investigate staged development of papillary thyroid carcinoma, we observed the histo-pathological findings of thyroid gland from BRAFV600E transgenic mice with a period of 60 weeks. MATERIALS AND METHODS: We histologically inspected 3, 9, 20, 27, 39, 44, 48 and 60 week old BRAFV600E transgenic mice derived from FVB/N background mice with a bovine thyroglobulin promoter which are providing thyroid specific BRAFV600E expression. RESULTS: Thyroid glands from 3 and 9 week old BRAFV600E transgenic mice were enlarged and showed abnormal histologic feature such as distorted follicular architectures. The 20 and 27 week old BRAFV600E transgenic mice showed irregularly enlarged thyroid gland sprouting out above the carotid arteries. Thyroid gland derived from 39 week old mice showed reduced formation of intact follicular structure and increased solid area. Thyroid glands were entirely replaced by firm tumor mass composed of poorly differentiated cell at 44 weeks. Interestingly, we could observe tracheal invasion, surrounding muscle invasion in thyroid gland from 48 week old mice and detect lung metastasis in 60 week old mice. CONCLUSION: Thyroid specific expression of BRAFV600E induced staged development of thyroid cancer. This finding may support that BRAFV600E have a role in entire carcinogenic process such as tumor initiation, development and progression.
Animals ; Carcinoma ; Carotid Arteries ; Lung ; Mice ; Mice, Transgenic ; Muscles ; Neoplasm Metastasis ; Proto-Oncogene Proteins B-raf ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms