PURPOSE: We studied the change of bronchial hyperresponsiveness(BHR) from childhood to early adulthood and to know the risk factors which influence on the persistence of BHR. METHODS: Seventy two atopic asthma children with nonspecific BHR to methacholine were observed for about 10 years, longitudinally. They were divided into 3 groups depend on the degree of BHR; no BHR group(A group), asymptomatic BHR group(B group), symptomatic BHR group(C group) and compared clinical and atopic findings, inflammation degree of airway, and environmental factors between the groups. RESULTS: In the group A, B, C, the number of subjects were, respectively, 15(20.8%), 19 (26.4%), 38(52.8%). The frequency of group C was higher in the subjects with more severe asthma symptoms and higher BHR at diagnosis. The positive rates of skin prick test to Dp, Df, and pets, serum total IgE, sputum eosinophils, sputum ECP at the time of follow-up were significantly higher in group C. The frequency of subjects with carpets/sofa/bed, pets at home and smokers at the time of follow-up were higher in group B, C. CONCLUSION: Significant number of childhood asthma showed persistent nonspecific BHR in early adulthood. The persistence of nonspecific BHR in early adulthood was related with severity of asthma at diagnosis, laboratory findings and environmental factors at follow up.
Asthma* ; Child ; Clinical Laboratory Techniques ; Diagnosis ; Eosinophils ; Follow-Up Studies* ; Humans ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Risk Factors* ; Skin ; Sputum

Purpose: This study was conducted to identify the factors influencing organizational commitment and resilience onpresenteeism in clinical nurses. Methods: The subjects were 202 nurses working at 5 hospitals in B city. The data were collected through questionnaires and analyzed by t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Work impairment was negatively correlated with organizational commitment and resilience. Perceived productivity was positively correlated with organizational commitment and resilience. Influencing factors on work impairment were organizational commitment (β=-.22 p=.005) and hardiness (β=-.16, p=.042), with 10% explanatory power. Influencing factors on perceived productivity were organizational commitment (β=.24, p=.002) and hardiness (β=.16, p=.042), with 11% explanatory power. Conclusion Based on this research, appropriate programs and policies that consider influencing factors such as organizational commitment and hardiness in resilience are needed to reduce the level of presenteeism in clinical nurses.

PURPOSE: Activation of T helper(Th) cells and secretion of cytokines play a pivotal role in the pathogenesis of asthma. Th2 cells secrete IL-4 and IL-5. IL-4 stimulates IgE production and IL-5 is related with hematopoiesis, chemotaxis and activation of eosinophils. IFN-gamma produced by Th1 cells and IL-12 produced by antigen presenting cells have an inhibitory action on IgE production. We examined the cytokine production by peripheral blood mononuclear cells(PBMCs) of atopic asthmatic children and its relation with clinical findings. METHODS: We measured IL-4, IFN-gamma, IL-5, IL-12 in serum and supernatants of stimulated PBMCs cultures in 32 children with moderate stable asthma and 17 healthy controls. They were compared with number of skin test positive allergens, serum total IgE, peak expiratory flow rate(PEFR), methacholine PD20, sputum eosinophils and eosinophil cationic protein(ECP). RESULTS: No difference in serum cytokines was found between patients and controls, except IL-5. In supernatants of stimulated PBMCs cultures, the concentration of IL-4, IL-5 was significantly increased and IFN-gamma, IL-12 was significantly decreased in patients compared with controls. IL-4 was related with total serum IgE and numbers of skin test positive allergens. IL-5 was related with sputum eosinophils and ECP. The serum total IgE was inversely and PEFR was directly related with IFN-gamma. CONCLUSION: In atopic asthmatics, Th1 cytokines were increased and Th2 were decreased in stimulated PBMCs cultures. IL-4 was related with atopy, IFN-gamma with lung function and IL-5 with airway inflammation.
Allergens ; Antigen-Presenting Cells ; Asthma* ; Chemotaxis ; Child ; Cytokines ; Eosinophils ; Hematopoiesis ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-12* ; Interleukin-4* ; Interleukin-5* ; Lung ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin Tests ; Sputum ; Th1 Cells ; Th2 Cells

PURPOSE: The aim of this study is to evaluate morphological changes of the medial nerve in patients with carpal tunnel syndrome (CTS) before and after endoscopic release of the transverse carpal ligament, and to correlate the ultrasonography (US) findings with the use of high resolution US and the surgical outcome for the median nerve. MATERIALS AND METHODS: Thirty patients with CTS confirmed by a clinical and electrophysiological study underwent high resolution US. The US instrumentation was equipped with a high frequency linear transducer to measure the cross sectional area, flattening ratio and swelling ratio of the medial nerve at the distal radioulnar joint, proximal and distal carpal tunnel before and three months after surgery. RESULTS: The cross sectional area (CSA) of the median nerve at the distal radioulnar level showed a decrease from 0.13 +/- 0.03 cm2 before surgery to 0.11 +/- 0.03 cm2 after surgery, and the CSA of the proximal carpal tunnel showed a decrease from 0.17 +/- 0.07 cm2 to 0.14 +/- 0.05 cm2; these differences were statistically significant. There was no statistically significant correlation between the morphological change and symptom improvement. CONCLUSION: This study confirmed a decreasing CSA of the medial nerve at the distal radioulnar and proximal carpal tunnel in a postoperative patient with CTS, as determined by the use of high resolution US. No association was found between a change in the CSA of the median nerve and symptom improvement. A further study based on multiple measurements of the median nerve with a longer period is necessary to establish the association between a change in the CSA of the median nerve and symptom improvement.
Carpal Tunnel Syndrome ; Humans ; Joints ; Ligaments ; Median Nerve ; Transducers

Objectives: ZZKetamine has been reported to have antidepressant effects or psychotomimetic effects. The aim of this study was to investigatethe behavioral effects of ketamine treatment at various sub-anesthetic doses in adolescent and adult naïve mice. Methods: ZZIn each experiment for adolescent and adult mice, a total of 60 male Institute of Cancer Research mice were randomly dividedinto 6 groups, which were intraperitoneally treated with physiological saline, 10, 20, 30, 40, and 50 mg/kg ketamine for consecutive3 days. At 1 day after last injection, the locomotor and depressive-like behaviors were evaluated in mice, using open field test (OFT)and forced swim test (FST), respectively. Results: ZZIn case of adolescent mice, ketamine dose was negatively correlated with total distance traveled in the OFT (Spearman’srho = -0.27, p = 0.039). In case of adult mice, we found significant positive correlation between ketamine dose and duration of immobilityin the FST (Spearman’s rho = 0.45, p < 0.001). Immobility time in the 50 mg/kg ketamine-treated mice was significantly higher comparedto the saline-treated mice (Dunnett’s post-hoc test, p = 0.012). Conclusions ZZWe found that the repeated treatment with ketamine could decrease the locomotor or prolong the duration of immobilityin mice as the dose of ketamine increased. Our findings suggest that sub-anesthetic doses of ketamine might induce schizophrenia-like negative symptoms but not antidepressant effects in naïve laboratory animals.

Objectives: ZZKetamine has been reported to have antidepressant effects or psychotomimetic effects. The aim of this study was to investigatethe behavioral effects of ketamine treatment at various sub-anesthetic doses in adolescent and adult naïve mice. Methods: ZZIn each experiment for adolescent and adult mice, a total of 60 male Institute of Cancer Research mice were randomly dividedinto 6 groups, which were intraperitoneally treated with physiological saline, 10, 20, 30, 40, and 50 mg/kg ketamine for consecutive3 days. At 1 day after last injection, the locomotor and depressive-like behaviors were evaluated in mice, using open field test (OFT)and forced swim test (FST), respectively. Results: ZZIn case of adolescent mice, ketamine dose was negatively correlated with total distance traveled in the OFT (Spearman’srho = -0.27, p = 0.039). In case of adult mice, we found significant positive correlation between ketamine dose and duration of immobilityin the FST (Spearman’s rho = 0.45, p < 0.001). Immobility time in the 50 mg/kg ketamine-treated mice was significantly higher comparedto the saline-treated mice (Dunnett’s post-hoc test, p = 0.012). Conclusions ZZWe found that the repeated treatment with ketamine could decrease the locomotor or prolong the duration of immobilityin mice as the dose of ketamine increased. Our findings suggest that sub-anesthetic doses of ketamine might induce schizophrenia-like negative symptoms but not antidepressant effects in naïve laboratory animals.

PURPOSE: To determine the usefulness of MR imaging for differentiation between infectious and non-infectiousbursitis. MATERIALS AND METHODS: MR images of 16 patients (18 lesions) in whom bursitis around the hip had beendiagnosed were analyzed for homogeneity of the bursa, the presence of septation, the enhancement pattern, andassociated findings. Clinical data (symptoms and signs, laboratory data, aspiration of the bursa, and surgicalfindings) were available for correlation. The location of bursitis was trochanteric (n=9), ischiogluteal (n=5),iliopsoas (n=3), or ischiotrochanteric (n=1). RESULTS: Etiologies included infection in seven cases (3 pyogenic; 4tuberculous) and noninfecti-on in 11 (6 inflammation; 3 hemorrhage; 2 metabolic disease). In seven patients withinfectious bursitis, T1-weighted enhanced image revealed thick rim enhancement of the bursa (n=7) association withchanges in bone marrow signal intensity (n=2), bone erosion (n=2), and cellulitis (n=1). Of 11 cases ofnoninfectious bursitis, three demonstrated typical signal characte-ristics of hematoma within the distended bursa.In six of seven patients who underwent contrast-enh ancement, thick and thin peripheral enhancement of the bursawas noted. Bone erosion was found in one case of tuberculous bursitis and two of metab-olic disease. Internalseptation (n=4) and internal debris (n=3) were found in both infected and noninfected patients. CONCLUSION: MRimaging plays an important role in the diagnosis of bursitis around the hip. MR findings of thick rim enhancement,associated cellulitis, and changes in bone marrow signal intensity are suggestive of infectious bursitis.
Bone Marrow ; Bursitis* ; Cellulitis ; Diagnosis ; Femur ; Hematoma ; Hemorrhage ; Hip* ; Humans ; Inflammation ; Magnetic Resonance Imaging

PURPOSE: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. METHOD: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. RESULT: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient, " "selective food eating, " "steady exercising, " "getting rid of stress, " and "preparing for death". The intervening conditions, "supportive system, " "forms of life, " and "burden on family, " influenced overcoming cancer. CONCLUSION: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.
Data Collection ; Eating ; Female ; Humans ; Uterine Cervical Neoplasms

PURPOSE: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. METHODS: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. RESULTS: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. CONCLUSION: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.
Anesthesia ; Cooperative Behavior ; Curriculum ; Floors and Floorcoverings ; Humans ; Massage ; Surveys and Questionnaires ; Respiration ; Retrospective Studies ; Students, Nursing ; Women's Health

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare multisystem disorder that frequently involves the central nervous system (CNS). We compared the clinical characteristics, treatment, and prognosis of patients with HLH according to the degree of CNS involvement. METHODS: The clinical manifestations, initial laboratory data, treatment, and outcomes for 50 patients diagnosed with HLH and treated at Asan Medical Center between January 1995 and August 2011 were retrospectively reviewed and analyzed. CNS involvement was defined as the presence of neurological symptoms or an elevated white blood cell (WBC) count in the cerebrospinal fluid (CSF). RESULTS: Among these 50 patients, 23 (46%) developed CNS disease. Among patients with CNS disease, 19 had neurological symptoms, including seizures, altered consciousness, facial palsy, dysarthria, and dysphagia. Four patients had elevated CSF WBC counts without neurological symptoms. Twelve patients had abnormal brain imaging results, including high signal intensity lesions on T2-weighted magnetic resonance imaging (MRI) findings, ventriculomegaly, hemorrhage, atrophy, and leptomeningeal enhancement. Patients with CNS disease had lower ferritin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels as well as reduced 5-year survival as compared to those without CNS disease. CONCLUSION: CNS involvement is common among patients with HLH. Overall, patients with CNS disease achieve poorer outcomes than patients without CNS involvement. To improve outcomes, physicians must carefully monitor the neurological manifestations in patients with HLH and administer the appropriate course of intensified chemotherapy to patients with CNS disease.
Alanine Transaminase ; Aspartate Aminotransferases ; Atrophy ; Central Nervous System ; Central Nervous System Diseases ; Consciousness ; Deglutition Disorders ; Dysarthria ; Facial Paralysis ; Ferritins ; Hemorrhage ; Humans ; Leukocytes ; Lymphohistiocytosis, Hemophagocytic ; Magnetic Resonance Imaging ; Neuroimaging ; Neurologic Manifestations ; Organothiophosphorus Compounds ; Prognosis ; Retrospective Studies ; Seizures