Primary sclerosing cholangitis is a chronic disease of unknown cause, characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation. With increasing knowledge of primary sclerosing cholangitis, it is now recognized that in the setting of inflammatory bowel disease, cholangiocarcinoma is a complication of primary sclerosing cholangitis. We recently experienced a case of 41 year old female patient who had Crohns disease associated with primary sclerosing cholangitis and cholangioearcinoma. We report a case of primary sclerosing cholangitis with cholangiocarcinoma with literature review.
Adult ; Biliary Tract* ; Cholangiocarcinoma* ; Cholangitis, Sclerosing* ; Chronic Disease ; Constriction, Pathologic ; Crohn Disease ; Female ; Fibrosis ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Pancreas*

We wished to select a cold-adapted genotype G1P[8] ZTR-68 rotavirus (China southwest strain) in MA104 cells for possible use as a live vaccine. ZTR-68 was recovered originally from children with diarrhea. The virus was cultivated at 37 degrees C at the first passage. Then, the cultivation temperature was decreased stepwise by 3 degrees C per eight passages. In total, the virus was passaged 32 times, and cultivation was terminated at 28 degrees C. Biological characteristics of the virus were analyzed during serial passages. There was no difference between the migration patterns of genomic dsRNA segments according to polyacrylamide gel electrophoresis of original and cold-adapted viruses. Infectious and red cell-agglutination titers of cold-adapted virus were lower than those of the parent virus. Also, the virus formed small-size plaques with irregular shapes at 31 degrees C and 28 degrees C. These results suggested that a genetically stable attenuated virus can be obtained through serial cold-adapted passages. Thus, an alternative strategy is provided by cold-adaption for development of attenuated live rotavirus vaccines.
Adaptation, Physiological ; China ; Cold Temperature ; Diarrhea ; virology ; Female ; Genotype ; Humans ; Infant ; Male ; Rotavirus ; genetics ; growth & development ; isolation & purification ; physiology ; Serial Passage ; Virus Cultivation ; Virus Replication

In order to develop a self-report scale measureing posttraumatic distress, the authors translated Horowitz's(1979) Impact of Event Scale(IES) in Korean and explored its reliability and validity. The IES, BDI, STAI-I, II and MMPI-PTSD were administered to 143 college students and 104 patients who had experienced auto vehicle accident. The internal consistency(item-total correlation, students: r=.52, patients: r=.58:Cronbach's alpha, students: alpha=.87, patients: alpha=.89) and test-retest reliability (r=.73) were psychometrically approvable. To examine the validity, patients who were classified PTSD and non-PTSD were compared with IES, BDI, STAI-I, II and MMPI-PTSD. There were significant group differences in IES, BDI, and MMPI-PTSD. The IES was significantly correlated with BDI, STAI-II, and MMPI-PTSD. It was more highly correlated with MMPI-PTSD than BDI or STAI. The results of factor analysis suggested a single factor. IES showed sufficient discriminant validities between PTSD and non-PTSD(74.4%). Finally, the usefulness of the scale, some limitations, and implications for future study were discussed.
Humans ; Reproducibility of Results* ; Stress Disorders, Post-Traumatic

BACKGROUND: Impairment of relaxing response and augmentation of contractile response to vasoactive substances have been reported in atherosclerotic arteries. These alterations in vascular reactivity are considered as an underlying mechanism for the development of acute vasospasm in atherosclerotic coronary artery. Recently, it has been reported that lysophophatidylcholine (LPC), an oxidative metabolite of low density lipoprotein causes this functional abnormality. However, the precise mechanism of LPC induced change of vascular reactivity is still uncertain. METHOD: In this study, to elucidate the underlying mechanisms of abnormal vascular reactivity in atherosclerotic coronary artery, we examined the effect of LPC on whole cell K+current using patch clamping technique in rabbit coronary smooth muscle cells. RESULTS: Application of LPC(1microM) showed dual effect on whole cell outward current which depends on the magnitude of test potentials. At relatively high depolarizing test potentials (> 10 mV), LPC increased amplitude of outward current which was blocked by Gd3+ not by iberiotoxin (100 nM) and TEA (1 mM). Reversal potential of this Gd3+sensitive, LPC-induced current was -9.7 +/- 0.6 mV. At less depolarizing test potentials (< 10 mV), LPC decreased whole cell K+currents in a dose dependent manner (from 0.01 to 10 microM) in the range of -30 mV to +0 mV. Half maximal inhibition of K+current was 1.509 microM at 0 mV test potential (n =5). Depolarizing holding potential (0 mV) prevented this LPC-induced inhibition of K+current. Steady state activation and inactivation parameters of K+current were significantly shifted to the positive direction by application of LPC (p < 0.01, n =8). Pretreatment of staurosporine (100 nM), a blocker of protein kinase C partially blocked LPC-induced decrease of K+currents. CONCLUSION: LPC-induced inhibition of voltage dependent K+current may explain abnormal vascular reactivity in atherosclerotic coronary artery.
Arteries ; Constriction ; Coronary Vessels ; Lipoproteins ; Lysophosphatidylcholines* ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Protein Kinase C ; Staurosporine ; Tea

BACKGROUND: A hand hygiene policy has been introduced by the Joint Commission International Accreditation Standards for Hospitals (JCI); the purpose of this policy is to ensure that systematic standards are continuously practiced at hospitals in order to improve the quality of medical care and the safety of patients and health care workers. This policy requires that phlebotomists wear new gloves and disinfect their hands before attending a patient to prevent nosocomial infections and to protect the phlebotomists. This study aimed to assess the responses of patients and guardians regarding the hand hygiene procedures. METHODS: Between January and February 2010, a questionnaire survey was performed at our hospital for 310 outpatients, 93 inpatients, and 189 guardians. RESULTS: In all, 70.8% of respondents answered that phlebotomists did not require considerable time to remove and wear gloves, and 69.9% responded that phlebotomists could readily detect veins even with their gloves on. Besides, 81.9% respondents thought that it was sanitarily important for phlebotomists to remove their gloves and disinfect their hands after a venipuncture, whereas only 2.8% thought that this practice caused discomfort. CONCLUSION: The patients and guardians recognized that the hand hygiene procedures were important for their own safety and encouraged their application rather than considering them uncomfortable or inappropriate. Introduction and maintenance of the hand hygiene policy of JCI would not be difficult because patients or guardians recognized its importance.
Accreditation ; Cross Infection ; Surveys and Questionnaires ; Delivery of Health Care ; Dietary Sucrose ; Gloves, Protective ; Hand ; Hand Disinfection ; Hand Hygiene ; Humans ; Inpatients ; Joints ; Outpatients ; Phlebotomy ; Veins

We produced two murine monoclonal antibodies designated S2E1 and S2C11, which recognize S antigen of hepatitis B virus (HBsAg). S2E1 could bind to denatured form of recombinant HBsAg as well as native form of HBsAg, but S2C11 could bind only to native form of HBsAg. Both antibodies reacted with HBsAg in the hepatocyte of patient infected with hepatitis B virus. Analyses of the nucleotide sequences encoding the variable regions of these antibodies revealed that S2E1 and S2C11 utilize variable gene segment which belong to V4/5 gene family and utilize the J5 and Jk4 gene segments, respectively. In addition, the heavy chain of S2E1 express a member of V14 gene family and a member of DSP2.9 and Jh3 gene families. S2C11 is related to the V1 gene family and expresses DFL16.1 gene regions in conjunction with the Jh3 gene segment.
Antibodies ; Antibodies, Monoclonal* ; Base Sequence ; Clone Cells* ; Cloning, Organism* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatocytes ; Humans

OBJECTIVES: This study aimed to report the incidence of chronic posttraumatic stress disorder (PTSD), to identify psychosocial risk factors posttraumatically affecting the severity of PTSD symptoms, to compare the pattern of symptom changes over time, and to find early self-rated measures for the prediction of chronic PTSD in the patients physically injured by motor vehicle accident. METHOD: One-hundred-and-four motor vehicle victims, who were systematically recruited for the study of Kim et al(1998), were reevaluated through interview and questionnaire after twenty-four months. Clinician Administered PTSD Scale(CAPS), Beck Depression Inventory(BDI), Spiel-berger State Trait Anxiety Inventory(STAI), Impact of Event Scale(IES), questions about socioen-vironmental experiences after accident, and The Ways of Coping Checklist(WCC) were included in follow-up assessment. Of these subjects, 68 victims participated in CAPS interview and only 54 victims finished CAPS Interview, and questionnaire. The subjects with PTSD at initial and follow-up assessment were classified as the chronic PTSD group, subjects who recovered from PTSD at follow-up assessment were classified as the recovered group, and subjects who did not meet criteria for PTSD at initial and follow-up assessment were classified as the non-PTSD group. RESULTS: The prevalence of PTSD in motor vehicle victims was 39.8% in follow-up assessment. Compensation of disabilities, return to previous job and financial difficulty were associated with chronicity and poor psychological adjustment of PTSD. In total group of victims, PTSD symptoms that appeared at initial assessment were improved or disappeared at follow-up assessment. However, avoidance and numbing symptoms significantly increased in chronic PTSD group and "acting or feeling as if event were recurring" and "exaggerated startle response" were not recovered over time in recovered group. Only IES at initial assessment showed significant differences among Non-PTSD, PTSD and recovered group. BDI, STAI-II, active coping and passive coping at follow-up assessment showed significant differences among three groups. IES at initial assessment contributed 18.6% to CAPS variance at follow-up. CONCLUSION: This study showed a high risk of developing PTSD among physically injured victims after motor vehicle accident. Risk factors such as event severity, compensation of disabilities, return to previous job and financial difficulty were identified. High IES score at initial assessment was regarded as major factor affecting chronic PTSD.
Emotional Adjustment ; Anxiety ; Compensation and Redress ; Depression ; Follow-Up Studies ; Humans ; Incidence* ; Motor Vehicles* ; Prevalence ; Prospective Studies* ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*

PURPOSE: The purpose of this phenomenological study was to understand the experiences in the transplantation coordinators' practice. METHOD: Data was collected through a tape-recorded in-depth interview from nine participants who were transplantation coordinators of their hospitals. It was analyzed using the phenomenological method proposed by Colaizzi(1978). RESULTS: From significant statements, six categories of themes were integrated into the essential structure of the experiences of transplantation coordinators. Six categories of themes were 'continue to be professional during dash this way and rush that', 'burden due to persistent heavy work', 'the uniqueness in family care of the brain-dead patients', 'support of family and a professional group', 'worthiness and achievement of the patients' recovery', and 'establishment of self-confidence as a coordinator'. CONCLUSION: Although the transplantation coordinators played various roles, they had a conflict in role identity due to poor working environments. The results of this study suggested that development of an educational program, an increase in understanding for the coordinators' role, and institutional support for better working conditions are needed to get professional acknowledgement for transplantation coordinators.
Adult ; Humans ; Interviews as Topic ; Mental Health ; Middle Aged ; Role ; *Specialties, Nursing ; *Transplantation/nursing

PURPOSE: The purpose of this study was to identified the male nurses' encounter in adapting themselves in the hospital settings dominated by the female nurses in number. METHOD: Data were collected through the in-depth interview of 16 male nurses and analysed through the grounded theory methodology. RESULT: The behaviors of male nurses for job-adaptation can be summarized as a series of struggles to consolidate their own ground. They have made tremendous efforts to hold their own ground in the nursing profession composed of a large numbers of female nurses, while they have experienced many difficulties and problems as minorities. They have struggled to adapt themselves professionally through efforts such as; challenging the social and professional barriers, identifying the job identity, empowering themselves through self-development and dedication, expanding their influence among colleagues. In spite of these efforts, they had the perception that nursing is not a lifelong occupation for them. Thus, they had tendency to find outlets of change to occupations. CONCLUSION: A specific strategy is needed to provide an environment that is helpful for males in integrating into and adapting to the nursing profession.