Reactive oxygen species (ROS) are widely generated in biological processes such as normal metabolism and response to xenobiotic exposure. While ROS can be beneficial or harmful to cells and tissues, generation of ROS by diverse anti-cancer drugs or phytochemicals plays an important role in the induction of apoptosis. We recently identified a derivative of naphthalene, MS-5, that induces apoptosis of an ovarian cell, CAOV-3. Interestingly, MS-5 induced apoptosis by down-regulating the ROS. Cell viability was evaluated by water-soluble tetrazolium salt (WST-1) assay. Apoptosis was evaluated by flow cytometry analysis. Intracellular ROS (H₂O₂), mitochondrial superoxide, mitochondrial membrane potential (MMP) and effect on cycle were determined by flow cytometry. Protein expression was assessed by western blotting. The level of ATP was measured using ATP Colorimetric/Fluorometric Assay kit. MS-5 inhibited growth of ovarian cancer cell lines, CAOV-3, in a concentration- and time-dependent manner. MS-5 also induced G1 cell cycle arrest in CAOV-3 cells, while MS-5 decreased intracellular ROS generation. In addition, cells treated with MS-5 showed the decrease in MMP and ATP production. In this study, we found that treatment with MS-5 in CAOV-3 cells induced apoptosis but decreased ROS level. We suspect that MS-5 might interfere with the minimum requirements of ROS for survival. These perturbations appear to be concentration-dependent, suggesting that MS-5 may induce apoptosis by interfering with ROS generation. We propose that MS-5 may be a potent therapeutic agent for inducing apoptosis in ovarian cancer cell through regulation of ROS.
Adenosine Triphosphate ; Apoptosis* ; Biological Processes ; Blotting, Western ; Cell Line ; Cell Survival ; Flow Cytometry ; G1 Phase Cell Cycle Checkpoints ; Membrane Potential, Mitochondrial ; Metabolism ; Ovarian Neoplasms* ; Phytochemicals ; Reactive Oxygen Species* ; Superoxides

OBJECTIVE: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. METHODS: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. RESULTS: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. CONCLUSION: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for postoperative pain management in general surgery patients in South Korea.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Drug-Related Side Effects and Adverse Reactions ; Electronic Health Records ; Fentanyl ; Hand ; Hospitals, Teaching ; Humans ; Ketorolac* ; Korea ; Nefopam* ; Pain Management* ; Pain, Postoperative ; Paresthesia ; Passive Cutaneous Anaphylaxis ; Prescriptions ; Product Labeling ; Retrospective Studies

BACKGROUND: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. METHODS: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. RESULTS: The monthly mean number of interventions increased from 8.0 (±5.7) to 31.7 (±12.8) (P < 0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. CONCLUSION: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.
Costs and Cost Analysis ; Electronic Health Records ; Humans ; Intensive Care Units ; Medication Reconciliation ; Nutritional Support ; Pharmacists ; Retrospective Studies

PURPOSE: The purpose of this case report is to describe the surgical procedure of pylorus preserving gastrectomy and treatment methods, and the nursing process for postoperative complications namely delayed gastric emptying. METHODS: This case study describes the treatment methods and nursing process for a patient who visited the emergency room because of delayed gastric emptying after a pylorus preserving gastrectomy. RESULTS: The symptoms of this patient were resolved by botox-injection, none per oral, total parenteral nutrition, nutrition education after diagnosis by using abdominal x-ray, gastric emptying study, upper gastrointestinal series, and esophagogastroduodenoscopy. CONCLUSION: According to the result of this case study, nurses should be informed about delayed gastric emptying and how to apply the correct nursing process to the patient.
Diagnosis ; Education ; Emergency Service, Hospital ; Endoscopy, Digestive System ; Gastrectomy* ; Gastric Emptying* ; Humans ; Nursing Process ; Nursing* ; Parenteral Nutrition, Total ; Postgastrectomy Syndromes ; Postoperative Complications ; Pylorus ; Stomach Neoplasms*

PURPOSE: The purpose of this study was to investigate nurses' awareness of psychological distress and delirium in cancer patients and job stress. METHODS: The participants were 256 nurses in a cancer general hospital. The nurses' awareness of psychological distress and delirium was investigated using a self-report questionnaire (1–4 scale) developed by the researcher. Psychological distress was measured by depression, anxiety, and insomnia. Job stress was measured using the Korean version of the Expanded Nursing Stress Scale (1–4 scale). RESULTS: The analysis of 9 questionnaires about nurses' awareness was divided into two factors: nurses' competence and importance. Nurses' competence results were 2.06 (depression), 2.17 (anxiety), 2.29 (insomnia), and 2.41 (delirium). Importance results were 3.23 (depression), 3.20 (anxiety), 3.15 (insomnia), and 3.37 (delirium). Most nurses have experienced nursing psychological distress and delirium in cancer patients, but only about a quarter have received the relevant education. Job stress was 2.52 and in subcategories, work load received the highest score 2.92. CONCLUSION: Nurses recognize that psychological distress and delirium in cancer patients are very important, but they are less aware of their competence. Therefore, it is suggested to develop an educational program to improve nurses' competence when dealing with psychological distress and delirium.
Anxiety ; Delirium* ; Depression ; Education ; Hospitals, General ; Humans ; Mental Competency ; Nursing ; Sleep Initiation and Maintenance Disorders

Erratum agreed to by all authors, editor in chief, publisher, and scientific society.

OBJECTIVE: Until now, there is minimal number of research for overall domestic status of orphan drug use in Korea. The purpose of this study is to identify the list of orphan drugs available in Korea and to understand the status of orphan drug usage in tertiary Hospitals and rare incurable disease Hospital. METHODS: We made domestic orphan drug lists based on available orphan drugs in Korea. Based on this lists, we conducted e-mail survey from August, 2014 to September, 2014 to identify domestic status of orphan drug usage including the availability and management of orphan drugs. RESULTS: There are three hundred and eighteen orphan drugs (184 ingredients) registered in Ministry of Food and Drug Safety. Among the three hundred and eighteen orphan drugs, Two hundred and twenty-eight drugs (102 ingredients) were selected. Information on each item was collected and documented with generic and brand names, manufacturers, wholesalers, indications, FDA approval status and insurance coverage. Forty-three tertiary hospitals and thirty-two rare incurable hospitals responded to the survey questionnaire (57.3%). According to the survey result, the antineoplastics and immunomodulating agents group has the highest percentage (40%) usage in the hospital. Of fortythree tertiary hospitals, thirteen hospitals manage orphan drugs separately (30.2%). Based on the reply, most of the healthcare professionals commented the drug information related to efficacy and safety including medication counseling of orphan drugs is insufficient. CONCLUSION: Through this study we anticipate providing an understanding of orphan drug usage status in Korea. We found the limited resources to the information on orphan drugs and this information requires updating on a regular basis. This can be the basis for further studies about preparing drug information, educational resources for rare disease patients.
Antineoplastic Agents ; Child ; Child, Orphaned* ; Counseling ; Delivery of Health Care ; Electronic Mail ; Humans ; Insurance Coverage ; Korea ; Orphan Drug Production* ; Rare Diseases ; Tertiary Care Centers*

PURPOSE: The aim of this study is to identify the characteristics of occupational accidents by work type among municipal sanitation workers. METHODS: The original data of occupational accidents in 2009 by Korea Occupational Safety & Health Agency were analyzed by frequency and percentage using the SAS Version 9.1. RESULTS: The types of occupational accident were as follows: slips and trips, falls, musculoskeletal disorders, traffic accident, collision, amputation, cut & puncture, crush injuries, strenuous movement and drop/fly. Slips and trips occurred most frequently in domestic waste collection and street sweeping. The traffic accident showed the highest incidence in food waste collection. Falls occurred most frequently in recycling waste collection. Musculoskeletal disorders showed the highest incidence in large waste collection. CONCLUSION: Depending on the work type, types of occupational accident were different. The results of this study can provide the information for the development of the occupational accident prevention programs of municipal sanitation workers.
Accidents, Occupational ; Accidents, Traffic ; Amputation ; Incidence ; Korea ; Occupational Health ; Phenothiazines ; Punctures ; Recycling ; Sanitation

PURPOSE: The purpose of this study was to develop a specialized education curriculum aimed at helping nurses prepare for running and managing a Maternal-Child Health Center (Postpartum Care Center). METHOD: This study was conducted by an academy and industry joint research group consisting of professors of Nursing, and nurses actually running a Postpartum Care Center. The group compiled job descriptions of nursing through document research, interviews and observation during site visits, surveys, and seminars. They then performed a feasibility study and developed the final curriculum. RESULT: The education curriculum is a 32-week (2semester) program compromised of a theory part (12 credits, 180 hours) covering maternal and infant care and business start-up and field practice (3 credits, 45 hours). Courses in the theory part include an antenatal care, overview and details of maternal care, starting a business and its management. Of these courses, the overview of a maternal care course was developed with web-based contents. Field practice is designed to give students opportunities to visit Postpartum Care Centers, observe the care provided, and get hands-on experience. CONCLUSION: The specialized education curriculum is a 32-week course comprised of 12 credits on theory of antenatal care, overview and details of maternal care, infant care, starting and operating a business and 3 credits of field practice.
Child ; Commerce ; Curriculum* ; Education* ; Feasibility Studies ; Humans ; Infant ; Infant Care ; Job Description ; Joints ; Maternal-Child Health Centers* ; Nursing ; Postnatal Care ; Running