BACKGROUND: The cell mediated immunity has an important role in the pathogenesis of tuberculosis. sIL-2R has been known as a sensitive marker of T lymphocyte activation. Elevated serum levels of sIL-2R have been found in patients with lymphoproliferative disorders, organ transplantation, autoimmune diseases, and various granulomatous diseases. Elevated levels of sIL-2R have been also found in the seam and pleural fluid of the patients with tuberculosis. To evaluate the diagnostic value of sIL-2R in the differentiation of tuberculous pleurisy and. nontuberculous pleurisy. We measured the level of sIL-2R in the sera and pleural fluids of 12 patients with tuberculous pleurisy and 32 patients with nontuberculous pleurisy. METHOD: Samples of pleural fluid and serum were centrifuged at 2500 rpm for 10 min to remove cell pellets. Soluble R-2R was measured with a sandwitch enzyme immunoassay using the Cellfree r Interleukin-2 Receptor Test kit( T-cell science, Inc. Cambridge, MA). RESULTS: The results obtained were as follows: 1) The sIL-2R level in pleural fluid of the patients with tuberculous pleurisy was higher than that of patients with nontuberculous pleurisy(P<0.005). 2) When the sIL-2R level above 5,000 u/ml in pleural fluid was used as the cut-off value to diagnose tuberculous pleurisy, it had a sensitivity of 84.6% and a specificity of 90.9%. 3) The sIL-2R level in the sera of the patients with tuberculous pleurisy was higher than that of patients with bacterial pleural effusions and normal control group(P<0.05) and there was no difference of levels compared with malignant pleural effusions and transudative pleural effusions(P>0.05). 4) In patients with tuberculous pleurisy, the mean concentration of sIL-2R in pleural fluid was higher than that in serum(P<0.005). CONCLUSION: These findings suggest that the measurement of elevated levels of pleural fluid sIL-2R in tuberculous pleurisy may be useful in the differential diagnosis between patients with tuberculous pleurisy and nontuberculous pleurisy.
Autoimmune Diseases ; Diagnosis, Differential ; Humans ; Immunity, Cellular ; Immunoenzyme Techniques ; Interleukin-2* ; Lymphocyte Activation ; Lymphoproliferative Disorders ; Organ Transplantation ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy* ; Sensitivity and Specificity ; T-Lymphocytes ; Transplants ; Tuberculosis ; Tuberculosis, Pleural*

PURPOSE: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. METHODS: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change, decisional balance, self-efficacy, and knowledge related to smoking. RESULTS: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. CONCLUSIONS: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation
Adolescent ; Cross-Sectional Studies ; Humans ; Rural Population* ; Smoke ; Smoking ; Smoking Cessation*

PURPOSE: This study was done to verify the reliability and validity of the Korean version of DMCI in Korean adolescents. METHODS: A methodological study design was used with Cronbach's alpha for reliability, and an exploratory factor analysis and contrasted groups approach for construct validity. DMCI was translated into Korean and tested with a sample of 406 adolescents in Korea. The data were analyzed using Cronbach's alpha, item correlation with total, principal component factor analysis, and t-test. RESULTS: The translated content of the DMCI was validated by nursing faculty members and translation equivalency was obtained. The Cronbach's alpha of the DMCI simplified with 18 items was .78. The factor analysis revealed three factors explaining 41.5% of total variance and the corresponding factors were self-observation (21.6%), self-judgement (11.4%), and self-confidence (8.6%). The mean score for the DMCI in the aggression group was significantly lower than the non-aggression group. CONCLUSION: Results of this study suggest that the Korean version of DMCI can used as a reliable and valid measure to assess decision making competency in Korean adolescents.
Adolescent ; Aggression ; Decision Making ; Faculty, Nursing ; Humans ; Korea ; Reproducibility of Results ; Child Health

PURPOSE: Regarding the respiratory function of patients with an artificial airway, this study compared the effects between normal saline with chest vibration and normal saline with expectorant mixture, administered before endotracheal suction. METHODS: The study was conducted in the ICUs of one university hospital located in Incheon. The experimental group I received normal saline with chest vibration administered before endotracheal suction while the experimental group II received normal saline with expectorant mixture administered before endotracheal suction. For respiratory function, PaO2, PaCO2, and O2 saturation were measured by ABGA at 3 minutes after endotracheal suction for both pre-test and post-test. RESULTS: The two groups were not different significantly regarding PaO2 level and O2 saturation after the treatments, while, the experimental group II had lower PaCO2 level than the experimental group I after the treatments (t = 2.075, p = .042). For experimental group II, post-test score of PaCO2 level was significantly lower than that of the pre-test score (t = 1.842, p = .075). CONCLUSION: The administration of normal saline with expectorant mixture before endotracheal suction reduced PaCO2 level and improved the respiratory function.
Humans ; Suction ; Thorax ; Vibration

PURPOSE: Regarding the respiratory function of patients with an artificial airway, this study compared the effects between normal saline with chest vibration and normal saline with expectorant mixture, administered before endotracheal suction. METHODS: The study was conducted in the ICUs of one university hospital located in Incheon. The experimental group I received normal saline with chest vibration administered before endotracheal suction while the experimental group II received normal saline with expectorant mixture administered before endotracheal suction. For respiratory function, PaO2, PaCO2, and O2 saturation were measured by ABGA at 3 minutes after endotracheal suction for both pre-test and post-test. RESULTS: The two groups were not different significantly regarding PaO2 level and O2 saturation after the treatments, while, the experimental group II had lower PaCO2 level than the experimental group I after the treatments (t = 2.075, p = .042). For experimental group II, post-test score of PaCO2 level was significantly lower than that of the pre-test score (t = 1.842, p = .075). CONCLUSION: The administration of normal saline with expectorant mixture before endotracheal suction reduced PaCO2 level and improved the respiratory function.
Humans ; Suction ; Thorax ; Vibration

Background: Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. Methods: The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. Results: In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. Conclusion This study suggests that the minimum dose (6 × 103CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.

Background: Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. Methods: The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. Results: In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. Conclusion This study suggests that the minimum dose (6 × 103CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.

BACKGROUND: Preoperative autologous donation is one of the most widely used methods of autotransfusion. However donation of predetermined units cannot often be achieved because of falling hematocrit with donations going on. We studied on the minimal effective dosage of recombinant human erythropoietin(rhEPO) used in preoperative autologous donation. METHODS: We conducted randomized trial of rhEPO in 45 adults for posterior spinal fusion procedures who had basal hematocrit less than 40 percent. The patients received either nothing(control group) or rhEPO(25 or 50 units/kg) intravenously twice a week for 21 days, during which time up to 3 units of blood was collected. Patients were excluded from donation when their hematocrit values were less than 33 percent. All patient received iron sulfate(256mg orally three times daily). RESULTS: The mean number of units collected per patient(mean+/-SD) was 3+/-0 for the 50-unit group(P<0.05 when compared with control group), 2.84+/-0.36 for the 25-unit group and 2.67+/-0.49 for the control group. The red cell volume donated by the patients who received rhEPO(347 ml, 325 ml) was greater than that donated by the control group(255 ml, P<0.05). The differences between hematocrits of the first and the third preoperative donations were significantly less in 50-unit group(1.50+/-2.05) and 25-unit group(1.51+/-1.85) than that of control group(3.73+/-1.66). Two patients of the 25-unit group and 5 patients of the control group required additional homologous blood postoperatively. And there were no significant differences in the pattern of postoperative changes of hemoglobin and hematocrit among each group. CONCLUSIONS: Fifty units per kilogram of body weight is considered appropriate to be the minimal effective dosage for preoperative autologous donation.
Adult ; Blood Transfusion, Autologous ; Body Weight ; Cell Size ; Erythropoietin* ; Hematocrit ; Humans* ; Iron ; Spinal Fusion

STUDY DESIGN: This is a retrospective study that focused on the perioperative complications when performing posterior arthrodesis for treating degenerative lumbar disorders in elderly patients. OBJECTIVES: We wanted to analyze the perioperative risk factors and the complications associated with posterior lumbar decompression and arthrodesis in patients who were sixty-five years of age or older. SUMMARY OF LITERATURE REVIEW: Lumbar arthrodesis is commonly done in elderly patients to treat degenerative spine problems. These patients may be at an increased risk for complications because of their age and their associated medical conditions. MATERIALS AND METHODS: We studied 111 patients who were over 65 years old and they were able to be followed up for more than 3 months after performing posterior arthrodesis during the recent 5 years. Sixty-one patients who had undergone posterolateral fusion (PLF) were classified as group A, and 50 patients who had undergone posterior lumbar interbody fusion (PLIF) using a PEEK cage were classified as group B. We analyzed their rates of complications and the causative factors, according to operative methods and age, and these complications occurred within 12 weeks after the operations. RESULTS: Complications occurred for 43 patients of group A, and for 26 patients of group B. The differences in the rates of complications were statistically significant, and group A had a more complications than did group B. The relations between medical problems and the incidence of perioperative complications were statistically significant for both groups. CONCLUSIONS: Elderly patients with medical problems should be made aware that they are at an increased risk for surgical complications, and attention hould be paid to controlling the blood loss and limiting the operative time. The PLIF using a PEEK cage was identified as a procedure that could reduce the perioperative complications.
Aged ; Arthrodesis ; Decompression ; Humans ; Incidence ; Ketones ; Operative Time ; Polyethylene Glycols ; Retrospective Studies ; Risk Factors ; Spine

BACKGROUND: The aim of this study is to determine the effect of high dose fentanyl on the test dose containing 15microgram epinephrine during propofol anesthesia. METHODS: One hundred patients with ASA physical status 1 were randomized to receive 2 mg/kg propofol with or without 10microgram/kg fentanyl at the induction of anesthesia (n = 50 each). Anesthesia was maintained with propofol 8 mg/kg/h and 67% nitrous oxide in oxygen. Each group of patients were further divided into a test dose group receiving 1.5% lidocaine 3 ml plus epinephrine 15microgram or a saline group receiving 3 ml of isotonic saline (n = 25 each). Heart rate (HR) and systolic blood pressure (SBP) were monitored for 4 min after intravenous injection of the study drugs. RESULTS: In the propofol and the propofol-fentanyl group, the intravenous injection of the test dose produced a HR increase > or = 20 bpm (conventional HR criterion) in 25 and 23 out of the total 25 patients, respectively. Therefore, in the propofol-fentanyl group, sensitivity, specificity, positive predictive value, and negative predictive value were 82%, 100%, 100%, and 92.6%. According to the modified HR criterion (HR increase > or = 10 bpm), all the values were 100%. All patients receiving test dose developed SBP increase > or = 15 mmHg. CONCLUSIONS: Our results indicate that both HR increase > or = 10 bpm or SBP increase > or = 15 mmHg are clinically applicable during propofol-nitrous oxide anesthesia with 10microgram/kg fentanyl.
Anesthesia* ; Blood Pressure ; Epinephrine ; Fentanyl* ; Heart Rate ; Humans ; Injections, Intravenous ; Lidocaine ; Nitrous Oxide ; Oxygen ; Propofol ; Sensitivity and Specificity