BACKGROUND/AIMS: Hepatic fibrosis in rat induced by thioacet amide shares similar morphological and biochemical characteristics with human liver cirrhosis. Thioacetamide (T AA) initially induces accumulation of collagen in Disse space and eventually leads to macro- and micronodular cirrhos is. Ito cell was believed to play a main role in hepatic fibrosis. And it s activity was known to be regulated by the expression of various genes. But little has been discovered about the upstream signal trans duction pathway of these genes in hepatic fibrosis. The expression of genesrelated to Ito cell activity was regulated by many transcription factors , the activity of which was regulated by protein kinase C( PKC) is oforms. So it is s upposed that PKC could be as s ociated with fibrosis in liver. METHODS: We investigated the correlation of PKC is oforms and It ocell activity in the course of hepatic fibrosis using TAA induced rat liver cirrhosis model. We used six week- old male rats , and administered 0.03% TAA in drinking water. The animals were sacrificed at 9, 20, and 30 weeks after TAA administration. The degree of hepatic fibrosis was evaluated by measuring the total amount of collagen.-SMA immunohist ochemical st aining of liver tissue was done to determine the Ito cell activity. The expression pattern of PKC isoforms was investigated by West ern blotting. RESULTS: In TAA- treated group, collagen cont ent and Ito cell activity did not increase until 30 weeks and 20 weeks of treatment , respectively, while in control group collagen cont ent and Ito cell activity were not detected. Collagen content showed linear correlation with Ito cell activity. This implied that the proliferation of activated Ito cells was prior to the increase of collagen content. In view of expression pattern of PKC is oforms, PKC alpha showed no difference in TAA- treated group and control group. In TAA-treated group, PKCbeta1 exhibited increased level of expression in both particulate and cytosolic forms at 9 weeks, while PKCdelta and PKC epsilon showed striking shift to particulated form. After 20 weeks, all of the PKC beta1, delta, and epsilon degenerated and showed remarkably decreased level of expression. This suggested PKC alpha had no relation to hepatic fibrosis,while PKC beta1, delta, and epsilon, showing activity at 9 weeks, were related to fibrosis og liver. In response to fibrogenic factors, molecules engaged in intracellular signal transduction pathway like PKC beta1, delta, and epsilon, began to change prior to the increase of Ito cell activity, morphologic changes and alterations of collagen content. CONCLUSION: Our results strongly suggest that the activity of PKC isoforms play an important role in early step of hepatic fibrosis, while accompanying Ito cell activity do in later step.
Animals ; Collagen ; Cytosol ; Drinking Water ; Fibrosis ; Hepatic Stellate Cells ; Humans ; Liver Cirrhosis* ; Liver* ; Male ; Protein Isoforms ; Protein Kinase C-epsilon ; Protein Kinases ; Rats ; Signal Transduction ; Strikes, Employee ; Thioacetamide ; Transcription Factors

PURPOSE: Communication in hospitals is one of the major factors in patient safety. So, the purpose of this study was to identify the relationship between intra-organizational communication satisfaction and the safety attitude of nurses in hospitals. METHOD: A descriptive survey design with convenience sampling was used. Data collection was done using a self-report questionnaire answered by 278 nurses from one university hospital located in Kyeoung-gi Province, Korea. RESULT: Intra-organizational communication satisfaction positively correlated with safety attitude (r=.747, p<.01). Among the 6 sub dimensions of safety attitude, perceptions of management (r=.675, p<.01), job satisfaction (r=.640, p<.01) and teamwork climate (r=.600. p<.01) were strongly related to intra-organizational communication satisfaction. Multiple regression analysis was done to identify explanation power of intra-organizational communication satisfaction against safety attitude. The model was significant (F=48.540, p<.01). Intra-organizational communication satisfaction accounted for 60.9% of variance in safety attitude (Adj R2=.609). CONCLUSIONS: The results of this study indicate that higher levels of intra-organizational communication satisfaction promote positive safety attitude in hospital nurses and that communication media quality is an important factor in patient safety attitude. Therefore, developing interventions to revitalize intra-organizational communication level based on communication media quality will help in the construction of positive safety attitude in nurses.
Climate ; Surveys and Questionnaires ; Job Satisfaction ; Patient Safety

BACKGROUND/AIMS: Liver cirrhosis is an end-stage liver disease. Ito cell is known to have central role in fibrogenes is of liver cirrhosis. But collagen content and Ito cell activity in liver cirr hosis have received little attention. So Ito cell activity and hepatocyte proliferation activity according to collagen content was investigated. WAF-1 and c- met were studied to evaluate the effect of cell cycle. METHODS: We analyzed 56 cases of liver cirrhosis ( viral:41, biliary:11, alcoholic:2, Wilson' s disease:2). Collagen content was measured by spectrophot ometry. Ito cell activity and prolifer ation index was measured by-SMA and Ki- 67 immunohistochemistry. RESULTS: In viral cirrhosis, high collagen group showed increased Ito cell activity compared to low collagen group. There was no difference in hepatocyte prolifer ation activity bet ween high and low collagen group in viral cirrhosis. In biliary cirrhos is, high collagen group showed increased Ito cell activity in septal zones compared to low collagen group. WAF- 1and c- met were negative in most of cases. CONCLUSION: Collagen content of liver cirrhosis is closely related to increment of activated Ito cells . Ito cell activity was prominent in septal zones than in parenchymal areas of viral cirrhosis and that was only significant in septal zones of biliary cirrhosis. There is no correlation bet ween collagen content and hepatocyte proliferation activity.
Cell Cycle ; Collagen* ; Fibrosis ; Hepatic Stellate Cells ; Hepatocytes* ; Immunohistochemistry ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Diseases ; Liver*

PURPOSE: In this study effects of a flipped learning-based psychiatric nursing practicum were evaluated for appropriateness with undergraduate nursing students who are digital natives and tech-savvy millennial students. METHODS: For this retrospective comparative study data from 146 undergraduate students (flipped learning group n=70, traditional learning group n=76) were evaluated for academic performance and life core competencies. RESULTS: There was no significant difference between the flipped and traditional learning groups in prior homogeneity tests. The academic performance of the flipped learning group was higher than the control group in all aspects, except for practical quiz scores. The flipped leaning group had significantly higher self-assessment scores for academic performance (t=2.77, p=.006) and therapeutic communication simulation scores (t=3.18, p=.002). In addition, they showed a significant increase in core life competencies after participating in the flipped-learning practicum (t=-8.56, p<.001). They showed significant increases in all subdomains except Identity-value [Socialization (t=-5.13, p<.001), Responsibility-practice (t=-3.52, p=.001), Problem-solving (t=-2.67, p=.010), Knowledge-construction (t=-2.48, p=.016), and Information-management (t=-5.54, p<.001)]. Nursing students in the flipped learning-based clinical practicum showed significant improvement in performance and life core competencies. CONCLUSION: These results suggest that as a student-centered pedagogy, flipped learning is an effective strategy for improving academic performance and core competencies.
Education, Nursing ; Humans ; Learning ; Population Groups ; Preceptorship ; Problem-Based Learning ; Psychiatric Nursing* ; Retrospective Studies ; Self-Assessment ; Students, Nursing ; Teaching

The purpose of this study was to investigate the effect of 3-month nutrition education (First Time Intervention, FI) + additional 3-month nutrition education (Repeated Intervention, RI) which was performed after the 8-month follow-up. FI was conducted during 0-3 months and RI for 11-14 months. Ninety-two subjects completed FI program, and 38 out of 92 subjects who received FI finished the RI. Anthropometric data, dietary assessment (24hr recall) and fasting blood analysis were measured at 0 month, 3 months, 11 months and 14 months time points. After FI (3 mo), waist circumference, triglycerides, total cholesterol were significantly decreased. At 11 month follow-up, body weight, BMI, hip circumference, SBP, DBP were significantly rebounced and HDL cholesterol was significantly decreased. Therefore, the effect of short-term nutrition education was not being sustained. After the secondary nutrition intervention (14 mo), waist circumference and hip circumference were again significantly decreased. Total diet quality index-international (DQI-I) score was significantly increased in both FI group and RI group. The changes in DQI-I scores were significantly correlated with the changes in body weight (r = -0.129, p < 0.05) and counts of nutrition education (r = 0.159, p < 0.05), indicating that effective nutrition education helps improve the diet quality leading to a possible role in CVD prevention among male workers. Although a short-term intervention seems to be a success, the effect was not retained in this study. Therefore, we suggest incorporating nutrition education as a routine program for male worker at worksite.
Body Weight ; Cholesterol ; Cholesterol, HDL ; Diet ; Fasting ; Follow-Up Studies ; Hip ; Humans ; Male ; Triglycerides ; Waist Circumference ; Workplace

Philadelphia-negative (Ph−) classical myeloproliferative neoplasms (MPNs) include polycythemia vera, essential thrombocythemia (ET), and primary myelofibrosis. Somatic driver mutations in the JAK2, CALR, and MPL genes serve as major diagnostic criteria of the Ph− MPNs and these mutations occur in a mutually exclusive manner. In this report, we describe the first case of ET harboring double mutations in JAK2 V617F and MPL. For MPL, the patient had multiple clones of MPL mutations: c.1543_1546delinsAGGG (p.Trp515_Gln516delinsArgGlu) and c.1546C>G (p.Gln516Glu). The JAK2 V617F allele burden in our patient is very low (4%) compared to the relatively high (17%–78%) allele frequency of MPL mutations. The low JAK2 mutant burden might be explained by preexisting clonal hematopoiesis before overt signs of MPNs, followed by the acquisition of a second oncogenic mutation of CALR or MPL leading to the MPN phenotype. This highlights that screening for a second driver mutation should be considered in patients with a low JAK2 mutant burden by reporting a 57-year-old Korean man with ET.

In myopathy patients, fat mass increases as the disease progresses, while lean body mass decreases. The present study aimed to investigate the overall nutritional status of Korean myopathy patients through surveys of diet and dietary habits, bioelectrical impedance analysis (BIA), and biochemistry tests, as well as the examination of related factors, for the purpose of using such findings as a basis for improving the nutritional status in myopathy patients. The energy intake of all participants was found to be insufficient at only 44.5% of Dietary Reference Intakes for Koreans 2010 (KDRIs 2010), whereas protein intake was sufficient at 89.8% of KDRIs 2010. Dietary fiber intake was found to be 58.4% of sufficient dietary fiber intake for adults according to KDRIs 2010. Calcium intake was found to be 55.0% and magnesium was 14.9% of the recommended calcium and magnesium intake for adults according to KDRIs 2010. With respect to quality of life (QOL), overall increase in QOL domain score showed significant positive correlations with vegetable fat intake (p < 0.05), vegetable protein intake (p< 0.05), and dietary fiber intake (p < 0.05). With respect to BIA, the mean phage angle of all participants was found to be 2.49 +/- 0.93degrees, which was below the cutoff value. As a study that examined nutrient analysis and dietary habits of myopathy patients in Korea, the present study is meaningful in providing the basic data for future studies that aim to present dietary guidelines for patients suffering from myopathy.
Adult ; Bacteriophages ; Biochemistry ; Body Composition* ; Calcium ; Diet ; Dietary Fiber ; Electric Impedance ; Energy Intake ; Food Habits ; Humans ; Korea ; Magnesium ; Muscular Diseases* ; Nutrition Policy ; Nutritional Status* ; Quality of Life ; Recommended Dietary Allowances ; Vegetable Proteins ; Vegetables

PURPOSE: To determine the impact of the Patient Safety Program on the safety culture of nursing department. METHODS: Patient Safety Program focused on medication safety was launched by QI team and patient safety committee. Patient Safety Program was composed of the establishment of improved reporting system as s way to learn from error, 'Patient Safety Guard' movement, and continuous education for medication safety. With one group pretest-posttest design, nurses' perception of the safety culture were measured with self-administered questionnaire. Subjects were all nurses and managers in nursing department of a tertiary teaching hospital in Seoul. Collected data from survey was statistically analyzed using t-test. RESULTS: Patient Safety Program had been continued for 20 months in participation of all nurses and managers. Safety culture was improved (pretest=2.84, posttest=2.90, p<.001; 4 point scale). CONCLUSIONS: This study indicates that there has been a statistically significant increase in the nurses' perception of safety culture. These findings suggest that Patient Safety Program had made great contribution toward system wide safety culture in the hospital. To improve safety culture, leadership supports and flexibility to apply tailored interventions to the hospital were required necessarily.
Hospitals, Teaching ; Humans ; Leadership ; Patient Safety ; Pliability ; Qi ; Surveys and Questionnaires

OBJECTIVES: The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. METHODS: We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. RESULTS: Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. CONCLUSION: Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.
Adolescent* ; Child* ; Education ; Education, Special ; Follow-Up Studies ; Hospitalization ; Humans ; Inpatients* ; Medical Records ; Mental Health ; Morinda ; Outpatients ; Retrospective Studies

PURPOSE: Bacillus Calmette-Guerin(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis. METHODS: The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis. RESULTS: Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt. CONCLUSION: Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.
Abscess ; Bacillus* ; Drainage ; Follow-Up Studies ; Humans ; Infant ; Isoniazid ; Lymph Nodes ; Lymphadenitis* ; Mycobacterium bovis ; Needles ; Pan American Health Organization ; Rifampin* ; Vaccination