The infant kidney is more vulnerable to infections than the adult kidney. It is common that acute pyelonephritis (APN) during infancy and early childhood manifests growth retardation of kidney, ultimately leading to chronic renal failure. However, little is known about the pathogenesis of renal growth retardation in APN in youth. To understand the mechanism underlying the cortical lesions, urinary tract infection was induced in infant rats. To induce ascending APN, saline solution containing Escherichia coli (ATCC No. 25922) 107 bacteria/ml was infused into the bladder through the 16 gage silicone cannula in three-week-old weaning Sprague Dawley rats (weight 50~60 g, n=66). In the normal control group (n=20), saline was infused. Experimental groups were divided according to the treatment into the APN group (APN without any treatment, n=23) and TRX group (APN with ceftriaxone treatment, n=23). After performing the histopathologic examination, including inflammatory score, fibrosis score, and tubular atrophy score, we measured the apoptosis index in the tubular cells of noninflammatory cortical area at post-infection week 1 and 3 by the in situ TUNEL method. Kidney weight was significantly decreased in the APN group compared with the normal group at postinfection week 1 and 3. In the APN group, tubulointerstitial inflammation with heavy neutrophilic infiltration was found mainly in the upper and lower poles of the kidney in both the first and third week groups. Fibrosis was dominant in the third week of the APN group. However, inflammation and fibrosis were not significantly improved by TRX treatment. The apoptotic index of tubular cells was significantly increased in noninflammatory cortical area in the first week of both APN and TRX groups. It decreased near the normal control value in the third week. TGF-beta1 protein expression was localized in the inflammatory area. There was no TGF-beta1 expression in the tubules of the noninflammatory area. These findings suggest that renal growth retardation in experimentally induced APN in infant rats is related not only with the inflammatory reaction itself but also with the increased apoptosis of tubular cells in noninflammatory area. Ceftriaxone alone does not eliminate the inflammation nor prevent growth retardation effectively.
Adolescent ; Adult ; Animals ; Apoptosis* ; Atrophy ; Catheters ; Ceftriaxone ; Escherichia coli ; Fibrosis ; Humans ; In Situ Nick-End Labeling ; Infant* ; Inflammation ; Kidney ; Kidney Failure, Chronic ; Neutrophils ; Pyelonephritis* ; Rats* ; Rats, Sprague-Dawley ; Silicones ; Sodium Chloride ; Transforming Growth Factor beta1 ; Urinary Bladder ; Urinary Tract Infections ; Weaning

PURPOSE: This study was conducted to develop an asthma management education program for preschool children using Roy's adaptation theory as a framework and examining the effects of this program on adaptation to asthma treatment. METHODS: A non-equivalent control group pre-post-test design was used with 43 preschool children diagnosed with asthma and required to be hospitalized for inhalation therapy. An intervention group (n=23) participated in the educational program and a control group (n=20) received regular treatment. The education program was conducted and evaluated from June 30 to October 31 2012, a maximum 3 times every 24 hours during hospitalization. Two nurses conducted the program using the teaching method of Gagne and Briggs; instruction design theory through questionnaires to measure perception of disease, behavior of adaptation to treatment with inhalation therapy. RESULTS: Effects of asthma management education program; scores for face-pain rating decreased and time of adaptation to treatment increased significantly in the experimental group compared to the control group but no significant differences were found for perception of the disease's cause and treatment. CONCLUSION: Results indicate that the asthma management education program has positive effects on adaptation to asthma treatment of preschoolers.
Adult ; Asthma/diagnosis/*therapy ; Behavior ; Child ; Child, Preschool ; Female ; Health Knowledge, Attitudes, Practice ; Hospitalization ; Humans ; Interviews as Topic ; Male ; Pain Management ; Patient Education as Topic ; *Program Evaluation ; Questionnaires ; Respiratory Therapy

Purpose: The purpose of this study was to explore the experience of case management for early psychosis and identify factors influencing care management. Methods: We conducted in-depth interviews with 10 mental health professionals who implemented the Social Treatment for Early Psychosis (STEP) program. The collected data were analyzed using qualitative content analysis. Results: The findings consisted of 4 categories and 15 subcategories. Case management should develop expertise considering the desires of young adults, and grew as experts by promoting family cooperation and coping with mental crises. Administrator's support and peer support programs had a positive impact, while the absence of collaborative systems with psychiatric institution were identified as limitations in the operating system of the basic center. Consulting and monitoring of the metropolitan center provided a foundation for case management at the basic center, while the government's support policy is needed to improve of working environment and set up the youth-friendly early intervention system. Conclusion The results suggest that case management for early psychosis requires multilateral and cooperative efforts by strengthening the capabilities of case managers, establishing an integrated case management network of basic and metropolitan centers, and expanding the government's human and physical infrastructure.

Purpose: The purpose of this study was to explore the experience of case management for early psychosis and identify factors influencing care management. Methods: We conducted in-depth interviews with 10 mental health professionals who implemented the Social Treatment for Early Psychosis (STEP) program. The collected data were analyzed using qualitative content analysis. Results: The findings consisted of 4 categories and 15 subcategories. Case management should develop expertise considering the desires of young adults, and grew as experts by promoting family cooperation and coping with mental crises. Administrator's support and peer support programs had a positive impact, while the absence of collaborative systems with psychiatric institution were identified as limitations in the operating system of the basic center. Consulting and monitoring of the metropolitan center provided a foundation for case management at the basic center, while the government's support policy is needed to improve of working environment and set up the youth-friendly early intervention system. Conclusion The results suggest that case management for early psychosis requires multilateral and cooperative efforts by strengthening the capabilities of case managers, establishing an integrated case management network of basic and metropolitan centers, and expanding the government's human and physical infrastructure.

The clinical cases presented here involve skeletal Class III malocclusion cases treated with maxillary protraction in a relaticely short period of time with good results. When used on young patients, satisfactory results were obtained in a short period of time, but even for those with less growth potential remainig, skeletal enhancement was still evident. However, data on the criteria of diagnosis or relapse following maxillary protraction is limited despite the number of studies on the subiect. The present study could not incude the observations on retention and relapse, and further studies in the future may include such observations.
Diagnosis ; Humans ; Malocclusion ; Orthopedics ; Recurrence

The purpose of this study is to evaluate the antibacterial effects of two liquid fluoride materials on Streptococcus mutans (S. mutans). Riva star aqua™ (SDI, Bayswater, Australia), which consists of silver fluoride (AgF, step 1) and potassium iodide (KI, step 2), and Fluor protector® (FP; Ivoclar Vivadent, Liechtenstein) were used for experimental groups. Experimental groups were divided into 4 groups : AgF, KI, AgF + KI and FP. For the positive control (PC) group, ampicillin was used, and the negative control group (NC) did not receive any additional treatment. Each group was divided into 30 and 50 µL groups by volume of liquid and applied to flat-coated S. mutans. The diameter of the zone of inhibition was measured. The PC and AgF groups showed larger diameters than other materials (p < 0.05), and the AgF group showed no significant difference from the PC group in the 50 µL group (p > 0.05). The FP group showed larger diameters than the AgF + KI group in the 30 µL (p = 0.009). The KI group did not show significant difference from the NC group (p > 0.05). AgF is comparable to ampicillin in antibacterial effects on S. mutans, and better than FP.

Rapid and correct diagnosis is essential for national tuberculosis (TB) control. A greater national concern for quality control (QC) of Mycobacterium tuberculosis (MTB) testing is required to improve the proficiency of domestic clinical laboratories using diverse testing protocols in private and public sectors. External quality assessment (EQA) is an important program accompanying internal QC in clinical TB laboratories. In Korea, the EQA program initiated in 2005 by the Korean Association of External Quality Assessment Service (KEQAS) has made remarkable progress in the harmonization of private and public sectors with governmental support since 2011. An integrative TB EQA program led by the KEQAS with financial support from the Korea Centers for Disease Control and Prevention provides optimized EQA materials for both public and private sectors. In 2017, the KEQAS implemented ‘The Next-Generation Proficiency Testing Program’ equipped with a centralized control system of QC material production and electronic data management, which increased the scale of operating programs from 46 to 54 and recruited 1,700 participants. The TB program was also expanded to provide three times EQA for private laboratories from 2 times a year. For TB EQA programs implemented via the Clinical Microbiology Subcommittee of the KEQAS, survey materials were distributed by sectional orders for tests such as acid-fast bacilli (AFB) smears, AFB culturing and identification, antituberculous drug susceptibility screening, AFB molecular diagnosis, and rapid detection of rifampin and isoniazid resistance. All survey materials were produced by sophisticated manufacturing processes and thoroughly analyzed by various commercial kits, targeted DNA sequencing, and whole-genome sequencing in pre- and post-manufacturing phases for advancement in the EQA program.
Centers for Disease Control and Prevention (U.S.) ; Clinical Laboratory Techniques ; Diagnosis ; Financial Support ; Isoniazid ; Korea ; Mass Screening ; Mycobacterium tuberculosis ; Private Sector ; Public Sector ; Quality Control ; Rifampin ; Sequence Analysis, DNA ; Tuberculosis

BACKGROUND: As stated in ‘The Action Strategy for Tuberculosis-Free Korea,’ last March, high-throughput, large-scale analytical instruments for interferon gamma release assays (IGRA) are demanded by many clinical laboratories using the QuantiFERON-TB Gold In-Tube assay (Cellestis/Qiagen, Australia). Agility (Dynex Technologies, USA) is an automated high-throughput enzyme linked immunosorbent assay analyser. The present study aimed to evaluate its accuracy and speed. METHODS: Pooled plasma was prepared using samples obtained after IGRA testing. Analyses of precision, linearity, cut-off evaluation, and comparison with conventional methods were performed for multiple Agility instruments according to the Clinical and Laboratory Standards Institute EP5-A3, EP6-A, EP9-A3 and EP12-A2 guidelines. The turnaround time and throughput were also analysed. RESULTS: The coefficient of variation range was 2.48%–4.0%, 7.01%–11.17%, and 9.69%–14.84% for the repeatability, between-run precision, and between-day precision analyses, respectively. The linearity ranged from 0 to 10.541. Comparison analysis presented a high concordance of Agility with the conventional instrument, DS2 (Dynex Technologies), and manual method for IGRA. The cut-off value of 0.35 IU/mL was well compatible with the C50. It was identified that the C50±20% contained the C5–C95 interval. The average turnaround time was 3.84 hours, from the submission of pre-treated samples to the reporting of results. The throughput was determined to be 290 tests during a routine working time of 8 hours. CONCLUSIONS: Agility showed high precision, linearity, concordance, and had a 2.5 times faster throughput than with the conventional and manual method. It could be useful for large-scale IGRA testing in latent tuberculosis infection screening project. Samples within C50±20% are suspected to show relatively low reporducible results of high inversion between postivie and negative.
Enzyme-Linked Immunosorbent Assay ; Interferon-gamma Release Tests ; Interferons ; Latent Tuberculosis ; Mass Screening ; Methods ; Plasma

Objectives: One of the main causes of tooth loss in Korea is dental caries, a chronic disease affecting individuals of all ages worldwide. The average decayed, missing, and filled teeth (DMFT) index, a measure of the caries experience of the population, has been stagnating in Korea for a number of years. The purpose of this study was to investigate the pattern of caries prevalence by tooth type, and to identify the characteristics and risk factors of the specific affected caries (SaC) and significant caries (SiC) groups in Korea’s 12-year-old children. Data were obtained from the 2018 Children’s Oral Health Survey. Methods: Data from a total of 22,303 subjects were included in the study. We grouped the data according to two DMFT-related indices, the SaC index, which includes all subjects who have experienced a carious lesion, and the SiC index, which includes the top one-third of the population by DMFT. We then analyzed the sociodemographic variables and oral health behaviors seen in these groups. Results: The average DMFT index for all the 12-year-old children was 1.89, and that of those in the SaC and SiC groups was 3.37 and 4.86, respectively. The teeth that were found to be most likely to develop caries were the mandibular and maxillary first molars, and the tooth associated with the highest mean DMFT index was the mandibular first premolar. Among the variables analyzed, perceived oral health status was the most influential variable in the SaC and SiC groups, followed by gender, and then the presence or absence of calculus. Household income was not a statistically significant variable. Conclusions The results of this study revealed the characteristics common to 12-year-old children who are vulnerable to caries. This will provide valuable information when planning dental disease management projects.

Purpose: The purpose of this study was to systematically review peer support services related to mental health services utilization by people with severe mental illness and to identify core strategies essential for effective peer support services. Methods: A systematic search was conducted using keywords in English, 4 electronic databases, including CINAHL, EMBASE, MEDLINE, and PubMed. Of the 1,305 publications identified, 14 studies were finally included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for the quality assessment. Results: The 14 studies consisted of 8 randomized controlled trials (RCTs), 4 cohort studies, and 2 quasi-experimental studies. Overall, peer support services were found to be effective in reducing hospitalization rates, hospitalization days, number of emergency room visits, and total medical costs. There was inconsistent evidence that the services were associated with positive effects on measures of psychiatric symptoms, quality of life, and social support. Conclusion Peer support services for people with severe mental illness can be a cost-effective way to increase crisis stabilization and continuity of treatment. The core strategies of the services is the development of structured programs to cultivate professional peer providers and the establishment of a cooperative system between mental health professionals and peer providers.