The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
Cell Line ; Coculture Techniques ; Collagen Type I ; Fibroblasts ; Humans ; Keratins ; Models, Theoretical ; Mouth Mucosa* ; Mucous Membrane ; Polydioxanone* ; Research Personnel ; Skin ; Tensile Strength ; Tissue Donors ; Transplants

PURPOSE: This study was a descriptive research to assess the level of and the relationship of related factors in the performance of end-of-life care by intensive care unit (ICU) nurses. METHODS: Participants were 238 ICU nurses from university and general hospitals. Data were collected, using structured questionnaires, and collected data were analyzed using t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis with SPSS/WIN 22.0. RESULTS: There were significantly positive effects between performance of end-of-life care and end-of-life care attitudes. Performance end-of-life care was negatively associated with end-of-life care stress and obstacles. Factors that significantly influenced ICU nurses' performance of end-of-life were end-of-life care stress, medical team in obstacles related to end-of-life care, and end-of-life care attitudes, which explained about 53% of the variance in the performance of end-of-life care. CONCLUSION: Findings indicate that hospital organizations should carry out stress management and counseling programs in order to lower ICU nurses' end-of-life care stress, and to enhance end-of-life care attitudes. In addition, concern needs to be given to the medical team which was one of the obstacles to end-of-life care. It is also necessary to decrease the heavy workload and increase the communication with medical workers.
Counseling ; Hospitals, General ; Intensive Care Units ; Terminal Care

Ischemic brain hippocampal formation has been developed to understand the relationship between delayed neuronal damage and the expression of NMDA receptor subunits[NR2A, NR2B], MAP2, and NF200 in ttle conditions of hypoxia. Changes of NR subunits[NR2A, 2B], MAP2 6nd NF200 in rat brain postsynaptic density[PSD] after hypoxic injury were investigated through immunoblot analyses. To understand the effect of Ca2+ influx through NMDA receptors on neuronal damage which is manifested by morphological change, cytoskeletal disruption was examined through H & E, toluidine blue and immunohistochemical studies. The expression of NR2B was increased than normal at 30 hours after hypoxia. At this time, the expression of MAP2 and NF200 was markedly decreased and their morphology was more eosinophilic than normal and then became darker with expanded perineuronal space. Irreversible neuronal cell damage in hypoxic hippocampal formation is most prominent in CA3 region of hippocampus and the process is triggered by Ca2+ influx through NR1/MR2B receptor channel at 30 hour after initial hypoxic insult. Ca2+ influx through NR1/MR2B receptor channel may activate intracellular proteases which would degrade cytoskeleton. Proteolysis of cytoskeleton leads to its reorganization and eventually damages normal function of cell membrane which causes neuronal cell death. And, morphological changes of neuronal cells in hypoxic conditions were manifested as red neurons in the stage of reactive change, and as dark neuron in the stage of late hypoxic cell damage.
Animals ; Anoxia* ; Brain ; Cell Death ; Cell Membrane ; Cytoskeleton ; Eosinophils ; Hippocampus* ; N-Methylaspartate ; Neurons ; Peptide Hydrolases ; Proteolysis ; Rats* ; Receptors, N-Methyl-D-Aspartate ; Tolonium Chloride

PURPOSE: This study was done to investigate the degree of self-efficacy, transplant-related knowledge, and other factors affecting compliance with a therapeutic regimen for liver transplant recipients. METHODS: Participants were 140 patients who had received a liver transplant at a tertiary hospital in Y City, Gyeongnam Province and made regular hospital visits as outpatients. A self-report questionnaire was used to collect the data and collection was done from December 4, 2017 to January 26, 2018. Data were analyzed using frequencies, percentages, means, and standard deviations, and t-test, ANOVA, Pearson's correlation coefficients. Multiple linear regression was performed using SPSS/WIN 21.0 program. RESULTS: Participants scored 113.29±20.95 (out of 150) on self-efficacy, 16.38±3.62 (out of 18) on transplant-related knowledge, and 148.30±31.06 (out of 200) on compliance with the therapeutic regimen. Analyzed of correlations among participant's self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen showed a significant positive correlation between self-efficacy and compliance with the therapeutic regimen (r=.64, p=.001), but no significant correlations were found between self-efficacy and transplant-related knowledge (r=−.01, p=.912) or between transplant-related knowledge and compliance with the therapeutic regimen (r=.06, p=.458). Multiple regression analysis showed that factors affecting compliance with the therapeutic regimen were state of re-transplantation (β=.17, p=.016) and self-efficacy (β=.53, p=.001). CONCLUSION: There is a need to apply a differentiated nursing intervention program considering the differences in patients' self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen.
Compliance ; Humans ; Linear Models ; Liver Transplantation ; Liver ; Nursing ; Outpatients ; Tertiary Care Centers ; Transplant Recipients

PURPOSE: To evaluate the clinical features of infectious keratitis in the western coastal area of Chungcheongnam-do, Korea. METHODS: We performed bacterial and fungal cultures in patients with findings of infectious keratitis. Any correlations between the culture results and the patients' place of residence, occupation, types of ocular trauma, contact lens wear, previous ocular disease, duration of treatment for complete recovery, time between the onset of symptom and beginning of treatment were evaluated. In addition, we assessed the antibiotic susceptibilities of the cultured organisms. RESULTS: We detected 34 (58.62%) among 58 cultures performed in 55 patients that were positive for organisms; 24 for Gram-positive bacteria, 17 for Gram-negative bacteria, 3 for fungi and 9 for polymicrobial infections. Coagulase-negative staphylococci (CNS) was the most frequent infection. The culture positivity rate was significantly higher (P=0.047) in patients with history of previous ocular disease but no correlations were detected with place of residence, type of ocular trauma or the timing of culture. The average treatment period was 33.95+/-30.59 days, which extended as the lesion size increased (P=0.003). CONCLUSIONS: Pseudomonas species are considered to be the most frequent cause of infectious keratitis in Korea. However, in our study, CNS were the most frequent culture-positive organisms and visual prognosis was poorer in the culture-positive group.
Coinfection ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Hypogonadism ; Keratitis ; Korea ; Mitochondrial Diseases ; Occupations ; Ophthalmoplegia ; Prognosis ; Pseudomonas

No abstract available.
Acupuncture ; Sarcoidosis

PURPOSE: This study was intended to investigate the migrating motor complex (MMC) changes after ileal bypass in ex-vivo mouse models. METHODS: Partial (side-to-side) and total bypass (occlusion of proximal part of bypassed loop) were performed on ileums of female Institute of Cancer Research mice. After 2 and 4 weeks, the bypassed segments were harvested and MMCs were recorded at 4 different sites ex-vivo. Amplitude, duration, interval, direction of propagation, and the area under the curve (AUC) of MMCs were measured and compared to those of the controls. RESULTS: In control mice (n = 7), most MMCs propagated aborally (91.1%). After 2 weeks of partial bypass (n = 4), there was a significant decrease in both amplitude and AUC, and orally-propagating MMCs increased significantly (45%, P = 0.002). Bidirectional MMCs (originating in the bypassed loop and propagating in both directions) were also observed (10%). The amplitude of the MMCs remained decreased at 4 weeks after partial bypass (n = 4), and neither the AUC nor the direction of propagation showed significant changes compared to 2 weeks. Similarly, in the total bypass model, both the amplitude and AUC of the MMCs decreased significantly compared to controls. In contrast to partial bypass, 95% of the MMCs within the bypassed loop propagated aborally after 2 weeks (n = 6), which was similar to the control state. After 4 weeks (n = 5), however, MMCs either lost their temporal relationship or completely disappeared. CONCLUSION: The changes in propagation direction of the MMCs in the partially bypassed loop may contribute to stagnation of bowel contents and the development of blind loop syndrome.
Animals ; Area Under Curve ; Blind Loop Syndrome ; Female ; Humans ; Ileum ; Jejunoileal Bypass ; Mice ; Myoelectric Complex, Migrating

PURPOSE: To report a case of pseudoexfoliation in the unaffected eye in a patient with ophthalmic artery occlusion. CASE SUMMARY: A 49-year-old female presented with sudden vision loss in her right eye. On the initial examination, best corrected visual acuity was 20/500 in the right eye, and 20/20 in the left eye. Intraocular pressure in both eyes was 17 mmHg. Fundus examination showed retinal edema and a cotton wool spot in the right eye. There was a filling delay of choroidal and retinal vessels in the fluorescein angiography. On the slit lamp examination, there was pseudoexfoliation material around the pupil margin and lens capsule in the unaffected eye but no evidence of glaucoma. At the six-month follow-up, best corrected visual acuity in the right eye improved to 20/30 and a retinal nerve fiber layer defect was found at the spot of the previous cotton wool spot. On the visual field examination, visual defects corresponded with a retinal nerve fiber layer defect. CONCLUSIONS: Pseudoexfoliation may be related to a systemic vascular disorder.
Choroid ; Exfoliation Syndrome ; Eye ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Glaucoma ; Humans ; Incidental Findings ; Intraocular Pressure ; Middle Aged ; Nerve Fibers ; Ophthalmic Artery ; Papilledema ; Pupil ; Retinal Vessels ; Retinaldehyde ; Vision, Ocular ; Visual Acuity ; Visual Fields ; Wool

PURPOSE: To report a case of Candida parapsilosis keratitis with atypical presentation demonstrated by subepithelial white dot deposits without peripheral inflammatory reaction. CASE SUMMARY: A 45-year-old woman with Stevens-Johnson syndrome had used topical corticosteroid and bandage contact lens due to recurrent epithelial defect and keratitis. Multiple subepithelial white dot deposits were revealed on the central corneal area without surrounding inflammation. The corneal lesion was improved after epithelial debridement with topical antibiotics and steroid eyedrops. A few months later, however, the corneal lesion recurred. Smear cytology was performed, and yeast-formed fungi and pseudohyphae were found. C. parapsilosis was identified in the culture study. Therefore, the topical steroid was withdrawn and 0.15% topical Amphotericin was applied. The corneal lesion improved and corneal opacity did not progress. CONCLUSIONS: The case reported in this study is C. parapsilosis keratitis with multiple subepithelial white dot deposits without typical presentations of fungal kertitis. Although no typical infectious indication was evident, infection should be suspected in patients who show abnormal corneal lesion under immunosuppressive treatment.
Amphotericin B ; Anti-Bacterial Agents ; Bandages ; Candida ; Corneal Opacity ; Debridement ; Female ; Fungi ; Humans ; Inflammation ; Keratitis ; Middle Aged ; Ophthalmic Solutions ; Stevens-Johnson Syndrome

BACKGROUND: Dermatologic practice occurs mainly in the outpatient setting. The reasons for, frequency, and impact of inpatient dermatologic consultation may be quite different from outpatient practice and there has been a lot of changes in dermatologic consultation recently. Several studies about characteristics of dermatologic consultation have been reported. OBJECTIVE: The purpose of this study was to examine the characteristics of inpatient dermatologic consultation in Ewha womans university hospital for 3 years and also to compare the result of the report in 1991. METHODS: During a period of 3 years (1996.2-1998.3), we prospectively recorded the demographics of the patients for whom consultation was requested, the final diagnosis of the dermatologic service, and the tests necessary to arrive at diagnosis, and reasons for dermatologic consultation. RESULTS: 1) The consulted patients were 1019 among 38,402 inpatients (2.7%). 2) The total number of male and female patients were 547(53.7%) and 472(46.3%), respectively (M:F = 1.2:1). 3) The most frequent age group was the 6th decade(18.4%) and the highest incidence of seasonal distribution was spring. 4) The patients in internal medicine were the most frequently consulted. 5) The most common dermatoses were eczema group, followed by drug eruption, fungal infection, viral infection, acne vulgaris, urticaria, etc. 6) Distribution of dermatoses according to seasons and individual departments was statistically different in various dermatoses. 7) Frequent causes of consultation were as follows : the dermatologic diseases or conditions 68.3%, the diseases related to treatment 12.3%, the skin lesions of systemic diseases 10.0%, the dermatologic tests 3.5%, and admission to other departments with dermatologic diseases 1.9%, respectively. 8) The rate of consultation for drug eruption was increased markedly compared to that of new patients at OPD in 1998. CONCLUSIONS: The characteristics of inpatient dermatologic consultation in our hospital have been changed and furthermore the characteristics were quite different from that of oupatient practice.
Acne Vulgaris ; Demography ; Diagnosis ; Drug Eruptions ; Eczema ; Female ; Humans ; Incidence ; Inpatients* ; Internal Medicine ; Male ; Outpatients ; Prospective Studies ; Seasons ; Skin ; Skin Diseases ; Urticaria