PURPOSE: Caffeine shows wide interindividual pharmacokinetic (PK) variation, and therapeutic drug monitoring (TDM) may be needed. The PK profile of caffeine in Korean preterm neonates was investigated, and factors influencing the clearance of caffeine were analyzed. METHODS: Fifty-nine preterm neonates receiving caffeine for apnea of prematurity were enrolled in the study (gestational age, 29.5±2.2 weeks and birth weight [BW], 1,318±358 g). Caffeine (20 mg/kg) was intravenously administered to each neonate as a loading dose, followed by a maintenance dose of 5-10 mg/kg/d. A total of 190 serum concentrations were measured for population PK analysis and modeling using nonlinear mixed-effects model (NONMEM®) software. RESULTS: The mean serum concentration of caffeine was 15.4±4.5 mg/L (range 7.8-33.0 mg/L). High serum concentrations (>20 mg/L) were noted in 36 samples (29%). At the first measurement of serum caffeine, the mean postmenstrual age was 33.9±2.3 weeks, mean BW was 1,802±471 g, mean duration of treatment was 7.4±9.4 days, and mean sampling time after the last dose was 21.8±2.1 hours. In the population PK analysis, the clearance was 0.033 L/h and volume of distribution was 0.371 L. Typical clearance was calculated as 0.0293×(BW/70)1.33. Among the subjects receiving 5 mg/kg/d caffeine, the most significant risk factor associated with high serum concentrations (>20 mg/L) was low BW (P=0.024). CONCLUSION: BW was the only covariate that influenced caffeine clearance in preterm neonates. Preterm neonates with low BW should be carefully monitored for apnea and adverse reactions in addition to undergoing TDM.
Apnea* ; Birth Weight ; Caffeine* ; Drug Monitoring ; Humans ; Infant, Newborn ; Infant, Premature* ; Pharmacokinetics* ; Risk Factors

No abstract available.
Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Bone Marrow Cells/cytology/pathology ; Female ; Flow Cytometry ; Fusion Proteins, bcr-abl/*genetics ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Humans ; Immunophenotyping ; Leukemia/*diagnosis/etiology ; Lymphoma, Large B-Cell, Diffuse/*drug therapy ; Phenotype ; Rituximab/administration & dosage

PURPOSE: Previous studies indicated conflicting results regarding the prognosis of gastric cancer with a family history (FHX). This study aimed to determine the clinicopathological features and survival of patients with gastric cancer with a FHX. MATERIALS AND METHODS: We reviewed 2,736 patients with gastric cancer who underwent surgery between 2003 and 2009. The prognostic value of a FHX was determined in the multivariate model after adjusting for variables in the Asian and internationally validated prognostic models. RESULTS: Of the patients, 413 (15.1%) had a FHX of gastric cancer. The patients with a FHX were younger (58.1 vs. 60.4 years; P<0.001) than the patients without a FHX. There were no significant differences in the histopathological characteristics between the 2 groups. A FHX was associated with a better overall survival (OS) rate only in the stage I group (5-year survival rate, 95% vs. 92%; P=0.006). However, the disease-specific survival (DSS) rate was not significantly different between the 2 groups in all stages. The multivariate model adjusted for the variables in the Asian and internationally validated prognostic models revealed that FHX has no significant prognostic value for OS and DSS. CONCLUSIONS: The clinicopathological features and survival of the patients with gastric cancer with a FHX did not significantly differ from those of the patients without a FHX.
Asian Continental Ancestry Group ; Humans ; Prognosis ; Stomach Neoplasms* ; Survival Rate

PURPOSE: The purpose of this study is to evaluate the impact of high-risk human papillomaviruses (HPVs) other than HPV 16/18 on the natural course of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL). MATERIALS AND METHODS: The study population was derived from the Korean HPV cohort (2010-2014). Women aged 20 to 60 who satisfied the criteria of having both HPV infection and abnormal cervical cytology of either ASC-US or LSIL were recruited from five institutions nationwide. Enrolled patients underwent cervical cytology and HPV DNA testing every 6 months. RESULTS: A total of 1,158 patients were enrolled. The 10 most common HPV types were HPV 16 (12.3%), 58 (10.0%), 56 (8.8%), 53 (8.4%), 52 (7.7%), 39 (6.2%), 18 (6.0%), 51 (5.7%), 68 (5.1%), and 66 (4.6%). Among these patients, 636 women were positive for high-risk HPVs other than HPV 16 or 18, and 429 women were followed for more than 6 months. Cytology evaluations showed progression in 15.3% of women, no change in 22.6%, and regression in 62.1% of women at 12 months. In cases of HPV 58 single infection, a more highly significant progression rate, compared to other high-risk types, was observed at 6 months (relative risk [RR], 3.3; 95% confidence interval [CI], 2.04 to 5.30; p < 0.001) and 12 months (RR, 5.03; 95% CI, 2.56 to 9.91; p < 0.001). CONCLUSION: HPV genotypes numbered in the 50s were frequent in Korean women with ASC-US and LSIL. HPV 58 was the second most common type, with a high progression rate of cervical cytology.
Atypical Squamous Cells of the Cervix ; Cohort Studies* ; Female ; Genotype* ; Human papillomavirus 16 ; Human Papillomavirus DNA Tests ; Humans ; Squamous Intraepithelial Lesions of the Cervix

PURPOSE: This study investigated the effects of father's occupational stress and rearing attitude on rearing participation. METHODS: The participants of this study were 201 fathers who are raising children in J region. The data were collected by self-report using questionnaires from August to September, 2015. The data were analyzed using descriptive statistics. t-test, ANOVA, and Pearson correlation coefficient, Scheffe test, and stepwise multiple linear regression with the SPSS/WIN 21.0 program. RESULTS: The total mean scores of occupational stress on the subjects were 40.98(±8.36), rearing attitude were 68.54(±7.18), rearing participation were 73.16(±11.34). The study showed that occupational stress is negatively correlated with rearing participation and rearing attitude positively correlated with rearing participation. Working style and rearing attitude were identified of rearing participation. CONCLUSION: A father's rearing participation level was influenced by father's attitude of caring children above all. In addition, fathers' working styles were also a main factor. Therefore, it is necessary for fathers to learn rearing attitudes in a way that can develop a nursing intervention program to increase their rearing participation level.
Child ; Child Rearing ; Fathers ; Foster Home Care ; Humans ; Linear Models ; Nursing

OBJECTIVES: This study was aimed at seeking an effective method of improving job satisfaction and practice performance of clinical dental hygienists by analyzing their job satisfaction factors. METHODS: Questionnaires were distributed to 210 clinical dental hygienists working at dental institutions in Busan, Gyeongnam, and Gyeongbuk, from the 25th of July through to the 30th of August, 2015, after receiving approval of the Institutional Review Board. The following conclusions were derived as a result of analyzing a total of 198 of the 210 questionnaires, 12 of which were excluded due to non-response or suspicious authenticity. RESULTS: Analysis of the job satisfaction according to the participants' general characteristics revealed significant differences in terms of marital status (P<0.001), age (P<0.001), education (P=0.002), income (P<0.001), and total work experience (P<0.001). Further, groups showing high scores on the internal marketing system, structural factors, communication system factors, and compensation factors had higher job satisfaction (P<0.01). Analysis of oral health education, a factor in the job satisfaction related to practice performance, was carried out by the high group. This led to high satisfaction with professional pride (P<0.01) and patient relationships (P<0.01). Preventive treatment, another factor in job satisfaction related to practice performance, led to high satisfaction with colleague relationships (P<0.05). The job satisfaction for medical cure cooperation tasks showed no significant differences. Administration and management tasks for high groups led to higher satisfaction with professional pride, ability to work, work environment, compensation, and patient relationships (P<0.01). CONCLUSIONS: These results show the need for an expansion in oral health education and preventive treatment tasks in order to ensure greater job satisfaction in dental hygienists. Additionally, the development of internal marketing systems within dental care institutions is necessary to further enhance and promote a sense of accomplishment at work.
Busan* ; Compensation and Redress ; Dental Care ; Dental Clinics* ; Dental Hygienists* ; Education ; Ethics Committees, Research ; Gyeongsangbuk-do* ; Humans ; Job Satisfaction* ; Marital Status ; Marketing ; Methods ; Oral Health

BACKGROUND/OBJECTIVES: This is the first study to identify common genetic factors associated with the basal metabolic rate (BMR) and body mass index (BMI) in obese Korean women including overweight. This will be a basic study for future research of obese gene-BMR interaction. SUBJECTS/METHODS: The experimental design was 2 by 2 with variables of BMR and BMI. A genome-wide association study (GWAS) of single nucleotide polymorphisms (SNPs) was conducted in the overweight and obesity (BMI > 23 kg/m2) compared to the normality, and in women with low BMR (< 1426.3 kcal/day) compared to high BMR. A total of 140 SNPs reached formal genome-wide statistical significance in this study (P < 1 x 10(-4)). Surveys to estimate energy intake using 24-h recall method for three days and questionnaires for family history, a medical examination, and physical activities were conducted. RESULTS: We found that two NRG3 gene SNPs in the 10q23.1 chromosomal region were highly associated with BMR (rs10786764; P = 8.0 x 10(-7), rs1040675; 2.3 x 10(-6)) and BMI (rs10786764; P = 2.5 x 10(-5), rs10786764; 6.57 x 10(-5)). The other genes related to BMI (HSD52, TMA16, MARCH1, NRG1, NRXN3, and STK4) yielded P <10 x 10-4. Five new loci associated with BMR and BMI, including NRG3, OR8U8, BCL2L2-PABPN1, PABPN1, and SLC22A17 were identified in obese Korean women (P < 1 x 10(-4)). In the questionnaire investigation, significant differences were found in the number of starvation periods per week, family history of stomach cancer, coffee intake, and trial of weight control in each group. CONCLUSION: We discovered several common BMR- and BMI-related genes using GWAS. Although most of these newly established loci were not previously associated with obesity, they may provide new insights into body weight regulation. Our findings of five common genes associated with BMR and BMI in Koreans will serve as a reference for replication and validation of future studies on the metabolic rate.
Basal Metabolism ; Body Mass Index ; Body Weight ; Coffee ; Energy Intake ; Female ; Genome-Wide Association Study* ; Humans ; Motor Activity ; Obesity ; Overweight* ; Polymorphism, Single Nucleotide ; Research Design ; Starvation ; Stomach Neoplasms

PURPOSE: The aim of this study was to examine the effects of hand massage with nail art on depression, self-esteem and vital signs of elderly women. METHODS: The research design was one group pre and post test experimental design. Data were collected from December 7 to December 14, 2015. All participants had hand massage with nail art for 10 minutes. Depression, self-esteem and vital signs were measured before, immediately after the hand massage with nail art and one week later. Data were analyzed using descriptive statistics and repeated measures ANOVA with SPSS/Win 12.0 Program. RESULTS: Depression (F=30.80, p<.001), self-esteem (F=60.02, p<.000), diastolic pressure (F=29.56, p<.001) and body temperature (F=13.87, p<.001) were significantly different compared to pre-study values. Systolic pressure (F=3.85, p=.059) and pulse rate (F=0.32, p=.576) had no significant difference compared to pre-study values. CONCLUSION: The findings of this research show that hand massage with nail art has positive effects on decreasing depression and improving self-esteem for senior women who chose nail polish colour by themselves.
Aged* ; Blood Pressure ; Body Temperature ; Depression* ; Female ; Hand* ; Heart Rate ; Humans ; Massage* ; Nursing Homes* ; Nursing* ; Research Design ; Vital Signs*

PURPOSE: To describe a case of exercise-induced anaphylaxis presenting with lower lid angioedema. CASE SUMMARY: A 35-year-old female patient for the past 3 years experienced lower lid edema in her left eye after exercising. In the treadmill exercise test, sneezing, coughing, and lower lid edema in her left eye appeared 13 minutes after initiating exercise. Additionally, contrast-enhanced computed tomography scan revealed minimal soft tissue thickening of the left inferior periorbital subcutaneous area with subtle enhancement after exercise. The serum immunoglobulin E (IgE) test showed elevated total IgE levels. The patient was diagnosed with exercise-induced anaphylaxis based on the above results. We informed the patient on her trigger factors and possible symptoms and prescribed an oral antihistamine and steroid. CONCLUSIONS: In patients presenting with facial edema or eyelid edema after exercise, the possibility of exercise-induced anaphylaxis should be considered. In addition, we have to aware of possibility of complication such as airway obstruction or a life-threatening condition, and it is needed to prevent a recurrence of anaphylaxis by cooperating with other department.
Adult ; Airway Obstruction ; Anaphylaxis* ; Angioedema* ; Cough ; Edema ; Exercise Test ; Eyelids ; Female ; Humans ; Immunoglobulin E ; Immunoglobulins ; Recurrence ; Sneezing

P450 1A2 is responsible for the metabolism of clinically important drugs and the metabolic activation of environmental chemicals. Genetic variations of P450 1A2 can influence its ability to perform these functions, and thus, this study aimed to characterize the functional significance of three P450 1A2 allelic variants containing nonsynonymous single nucleotide polymorphisms (P450 1A2*8, R456H; *15, P42R; *16, R377Q). Variants containing these SNPs were constructed and the recombinant enzymes were expressed and purified in Escherichia coli. Only the P42R variant displayed the typical CO-binding spectrum indicating a P450 holoenzyme with an expression level of approximately 170 nmol per liter culture, but no P450 spectra were observed for the two other variants. Western blot analysis revealed that the level of expression for the P42R variant was lower than that of the wild type, however the expression of variants R456H and R377Q was not detected. Enzyme kinetic analyses indicated that the P42R mutation in P450 1A2 resulted in significant changes in catalytic activities. The P42R variant displayed an increased catalytic turnover numbers (k(cat)) in both of methoxyresorufin O-demethylation and phenacetin O-deethylation. In the case of phenacetin O-deethylation analysis, the overall catalytic efficiency (k(cat)/K(m)) increased up to 2.5 fold with a slight increase of its K(m) value. This study indicated that the substitution P42R in the N-terminal proline-rich region of P450 contributed to the improvement of catalytic activity albeit the reduction of P450 structural stability or the decrease of substrate affinity. Characterization of these polymorphisms should be carefully examined in terms of the metabolism of many clinical drugs and environmental chemicals.
Biotransformation ; Blotting, Western ; Cytochrome P-450 CYP1A2* ; Escherichia coli ; Genetic Variation ; Metabolism ; Phenacetin ; Polymorphism, Single Nucleotide