PURPOSE: The purpose of this study was to examine the effect of a laughter therapy on pain, depression, and quality of life of elderly people with osteoarthritis. METHODS: A quasi-experimental, nonequivalent control group pretest-posttest design was used. Participants (n=60) included older adults who were diagnosed with osteoarthritis and received treatment at the out patient departments of two different hospitals. Data were collected from March 9 to 30, 2011. Experimental group (n=30) participated in laughter therapy four times, once a week for 50 min per session. Questionnaires were used to measure pretest and posttest levels of pain, depression, and quality of life. RESULTS: At the end of four-week intervention, pain (F=11.32, p=.001) and depression (F=10.77, p=.002) were significantly decreased in the experimental group. Quality of life (F=6.28, p=.015) were significantly improve in the experimental group. CONCLUSION: The study results suggest that the laughter therapy is an effective intervention to reduce the pain and depression, and to improve quality of life. It seems that this program can widely be utilized as one of nursing intervention programs for the elderly people with osteoarthritis.
Adult ; Aged* ; Depression* ; Humans ; Laughter Therapy* ; Laughter* ; Nursing ; Osteoarthritis* ; Quality of Life* ; Surveys and Questionnaires

The purpose of this study was to describe outcome indicators of nursing education including critical thinking, professionalism, leadership, and communication and to evaluate differences among nursing programs and academic years. A descriptive research design was employed. A total of 454 students from four year baccalaureate (BS) nursing programs and two three-year associate degree (AD) programs consented to complete self-administered questionnaires. The variables were critical thinking, professionalism, leadership and communication. Descriptive statistics, chi2-test, t-tests, ANOVA, and the Tukey test were utilized for the data analysis. All the mean scores of the variables were above average for the test instruments utilized. Among the BS students, those in the upper classes tended to attain higher scores, but this tendency was not identified in AD students. There were significant differences between BS students and AD students for the mean scores of leadership and communication. These findings suggested the need for further research to define properties of nursing educational outcomes, and to develop standardized instruments for research replication and verification.
Education, Nursing ; Humans ; Korea ; Leadership ; Research Design ; Statistics as Topic ; Students, Nursing ; Thinking ; Surveys and Questionnaires

PURPOSE: Whereas continuous renal replacement therapy (CRRT) has been utilized during liver transplantation (LT), there was a lack of evidence to support this practice. We investigated the adverse events at the perioperative periods in recipients of LT who received preoperative CRRT without intraoperative CRRT. METHODS: We retrospectively reviewed medical records of adult patients (age ≥ 18 years) who received LT between December 2009 and May 2015. Perioperative data were collected from the recipients, who received preoperative CRRT until immediately before LT, because of refractory renal dysfunction. RESULTS: Of 706 recipients, 42 recipients received preoperative CRRT. The mean (standard deviation) Model for end-stage liver disease score were 49.6 (13.4). Twenty-six point two percent (26.2%) of recipients experienced the serum potassium > 4.5 mEq/L before reperfusion and treated with regular insulin. Thirty-eight point one percent (38.1%) of recipients were managed with sodium bicarbonate because of acidosis (base excess <−10 mEq/L throughout LT). All patients finished their operations without medically uncontrolled complications such as severe hyperkalemia (serum potassium > 5.5 mEq/L), refractory acidosis, or critical arrhythmias. Mortality was 19% at 30 day and 33.3% at 1 year. CONCLUSION: Although intraoperative CRRT was not used in recipients with severe preoperative renal dysfunction, LT was safely performed. Our experience raises a question about the need for intraoperative CRRT.
Acidosis ; Adult ; Arrhythmias, Cardiac ; Humans ; Hyperkalemia ; Insulin ; Liver Diseases ; Liver Transplantation ; Liver* ; Medical Records ; Mortality ; Perioperative Period ; Potassium ; Renal Replacement Therapy ; Reperfusion ; Retrospective Studies ; Sodium Bicarbonate ; Transplant Recipients*

PURPOSE: Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. METHODS: We reviewed the medical records of 64 patients (M: F=33: 31, mean age: 6.3+/-7.5 months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care: < or =7 days (group 1: 23 cases, M: F=10: 13) and > 7 days (group 2: 41 cases, M: F=23: 18). RESULTS: The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1 (P< 0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different (P=0.082). Among underlying diseases, the most common diseases were vascular anomaly (26.2 percent) and aortic arch anomaly (26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect (22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis (in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13 (68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. CONCLUSION: Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.
Aorta, Thoracic ; Bronchoscopy ; Cardiovascular Diseases* ; Child* ; Chungcheongnam-do ; Heart Septal Defects, Ventricular ; Humans ; Infant* ; Medical Records ; Perioperative Period ; Prognosis ; Pulmonary Atresia ; Respiratory Sounds ; Tracheal Stenosis ; Tracheomalacia ; Ventilator Weaning ; Ventilators, Mechanical ; Weaning

Haploinsufficiency of A20 (HA20) is a newly described autoinflammatory disease caused by loss-of-function mutations in the TNFAIP3 gene. Clinical phenotypes are heterogenous and resemble Behçet's disease, juvenile idiopathic arthritis, inflammatory bowel disease, or periodic fever syndrome, with symptoms developing at an early age. Here, we report the first case of infantile familial HA20 in Korea, which mimics neonatal lupus erythematosus (NLE). A 2-month-old infant exhibited symptoms including recurrent fever, erythematous rashes, and oral ulcers, with elevated liver enzymes, and tested positive for several autoantibodies, similar to systemic lupus erythematosus (SLE); therefore, she was suspected to have NLE. However, six months after birth, symptoms and autoantibodies persisted. Then, we considered the possibility of other diseases that could cause early onset rashes and abnormal autoantibodies, including autoinflammatory syndrome, monogenic SLE, or complement deficiency, all of which are rare. The detailed family history revealed that her father had recurrent symptoms, including oral and genital ulcers, knee arthralgia, abdominal pain, and diarrhea. These Behcet-like symptoms last for many years since he was a teenager, and he takes medications irregularly only when those are severe, but doesn't want the full-scale treatment. Whole-exome sequencing was conducted to identify a possible genetic disorder, which manifested as pathogenic variant nonsense mutation in the TNFAIP3 gene, leading to HA20. In conclusion, HA20 should be considered in the differential diagnosis of an infant with an early-onset dominantly inherited inflammatory disease that presents with recurrent oral and genital ulcerations and fluctuating autoantibodies. Additionally, it also should be considered in an infant with suspected NLE, whose symptoms and abnormal autoantibodies persist.

BACKGROUND/AIMS: The relationship between Runt-related transcription factor 3 (RUNX3) gene inactivation and various solid tumors has been reported; however, little information is available about RUNX3 in thyroid cancers. METHODS: We evaluated the DNA methylation of RUNX3 in 13 papillary thyroid cancer tissues and four thyroid cancer cell lines. Additionally, using reverse transcriptase-polymerase chain reaction, we analyzed RUNX3 gene expression in several thyroid cancer cell lines after treating with the demethylating agent 5-aza-2'-deoxycytidine (DAC). RESULTS: RUNX3 was hypermethylated in many thyroid cancer cell lines and in 10 of the 12 papillary thyroid cancer tissues. Treatment with DAC increased the expression of RUNX3 in some thyroid cancer cell lines. CONCLUSIONS: We suggest that RUNX3 is associated with thyroid carcinogenesis, and RUNX3 methylation is a potentially useful diagnostic marker for papillary thyroid cancer.
Azacitidine/analogs & derivatives/pharmacology ; Carcinoma/*genetics ; Cell Line, Tumor ; Core Binding Factor Alpha 3 Subunit/*genetics ; DNA Methylation/drug effects ; Gene Expression/drug effects ; Humans ; Thyroid Neoplasms/*genetics ; Tumor Markers, Biological/genetics

BACKGROUND: Simian virus 40 (SV40), a polyomavirus, was discovered as a contaminant of a human polio vaccine in the 1960s. It is known that malignant mesothelioma (MM) is associated with SV40, and that the virus works as a cofactor to the carcinogenetic effects of asbestos. However, the reports about the correlation between SV40 and MM have not been consistent. The purpose of this study is to identify SV40 in MM tissue in Korea through detection of SV40 protein and DNA. METHODS: We analyzed 62 cases of available paraffin-blocks enrolled through the Korean Malignant Mesothelioma Surveillance System and performed immunohistochemistry for SV40 protein and real-time polymerase chain reaction (PCR) for SV40 DNA. RESULTS: Of 62 total cases, 40 had disease involving the pleura (64.5%), and 29 (46.8%) were found to be of the epithelioid subtype. Immunostaining demonstrated that all examined tissues were negative for SV40 protein. Sufficient DNA was extracted for real-time PCR analysis from 36 cases. Quantitative PCR of these samples showed no increase in SV40 transcript compared to the negative controls. CONCLUSIONS: SV40 is not associated with the development of MM in Korea.
Asbestos ; DNA ; Humans ; Immunohistochemistry ; Korea ; Mesothelioma ; Pleura ; Poliomyelitis ; Polymerase Chain Reaction ; Polyomavirus ; Real-Time Polymerase Chain Reaction ; Simian virus 40 ; Viruses

OBJECTIVE: This study aims to investigate the effect of galantamine on caregiver time and activities of daily living(ADLs) in patients with mild to moderate Alzheimer's disease(AD) in a Korean population. DESIGN: Quasi-experimental study: A rndomized, double-blind, parallel-group clinical trial and a naturalistic longitudinal community study METHOD: For this 1-year prospective study, 138 patients residing in the community were recruited(baseline MMSE score of. 10-22). The two groups were composed of 72 patients treated with galantamine and 66 patients selected as the control group from an untreated community cohort of AD patients. The primary efficacy outcome was the caregiver time and the secondary efficacy measure was the Korean version of the Disability Assessment for Dementia(DAD-K) scale. RESULTS: The results of a mixed model analyses demonstrated reduced caregiver time and improved ADLs in galantamine group relative to baseline and compared with the community control group in this 1-year prospective study. Significant improvement in galantamine group observed in the DAD scores demonstrated beneficial effects of galantamine on delaying functional deterioration in patients with mild to moderate AD. Difference in caregiver time between two groups was equivalent to additional 9.5 working days per month or 113 working days per year. CONCLUSION: Treatment with Galantamine is associated with a significantly slower decline in basic and instrumental ADLs in patients with mild to moderated AD. These benefits on functional capacity in patients with AD treated with galantamine were associated with less caregiver time, lower caregiver burden and higher economic benefits.
Activities of Daily Living* ; Alzheimer Disease* ; Caregivers* ; Cohort Studies ; Galantamine* ; Humans ; Prospective Studies*

BACKGROUND: There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. RESULTS:Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. RESULTS: The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. CONCLUSIONS: The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.
Ambulatory Care Facilities ; China ; Clinical Laboratory Techniques ; Emergencies ; Humans ; Infection Control ; Intensive Care Units ; Investments ; Korea ; Patients' Rooms ; Public Health ; SARS Virus ; Severe Acute Respiratory Syndrome* ; Surveys and Questionnaires

BACKGROUND: There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. RESULTS:Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. RESULTS: The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. CONCLUSIONS: The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.
Ambulatory Care Facilities ; China ; Clinical Laboratory Techniques ; Emergencies ; Humans ; Infection Control ; Intensive Care Units ; Investments ; Korea ; Patients' Rooms ; Public Health ; SARS Virus ; Severe Acute Respiratory Syndrome* ; Surveys and Questionnaires