OBJECTIVES: This paper describes an evaluation study on the effectiveness of developing an in-hospital medical device safety information reporting system for managing safety information, including adverse incident data related to medical devices, following the enactment of the Medical Device Act in Korea. METHODS: Medical device safety information reports were analyzed for 190 cases that took place prior to the application of a medical device safety information reporting system and during a period when the reporting system was used. Also, questionnaires were used to measure the effectiveness of the medical device safety information reporting system. The analysis was based on the questionnaire responses of 15 reporters who submitted reports in both the pre- and post-reporting system periods. RESULTS: Sixty-two reports were submitted in paper form, but after the system was set up, this number more than doubled to 128 reports in electronic form. In terms of itemized reporting, a total of 45 items were reported. Before the system was used, 23 items had been reported, but this increased to 32 items after the system was put to use. All survey variables of satisfaction received a mean of over 3 points, while positive attitude, potential benefits, and positive benefits all exceeded 4 points, each receiving 4.20, 4.20, and 4.13, respectively. Among the variables, time-consuming and decision-making had the lowest mean values, each receiving 3.53. Satisfaction was found to be high for system quality and user satisfaction, but relatively low for time-consuming and decision-making. CONCLUSIONS: We were able to verify that effective reporting and monitoring of adverse incidents and the safety of medical devices can be implemented through the establishment of an in-hospital medical device safety information reporting system that can enhance patient safety and medical device risk management.
Electronic Health Records* ; Equipment Safety* ; Hospital Information Systems ; Korea ; Patient Safety ; Risk Management ; Safety Management

Apigenin (4′,5,7-trihydroxyflavone) is a flavonoid commonly found in many fruits and vegetables such as parsley, chamomile, celery, and kumquats. In the last few decades, recognition of apigenin as a cancer chemopreventive agent has increased. Significant progress has been made in studying the chemopreventive aspects of apigenin both in vitro and in vivo. Several studies have demonstrated that the anticarcinogenic properties of apigenin occur through regulation of cellular response to oxidative stress and DNA damage, suppression of inflammation and angiogenesis, retardation of cell proliferation, and induction of autophagy and apoptosis. One of the most well-recognized mechanisms of apigenin is the capability to promote cell cycle arrest and induction of apoptosis through the p53-related pathway. A further role of apigenin in chemoprevention is the induction of autophagy in several human cancer cell lines. In this review, we discuss the details of apigenin, apoptosis, autophagy, and the role of apigenin in cancer chemoprevention via the induction of apoptosis and autophagy.
Apigenin* ; Apium graveolens ; Apoptosis* ; Autophagy* ; Cell Cycle Checkpoints ; Cell Line ; Cell Proliferation ; Chamomile ; Chemoprevention ; DNA Damage ; Fruit ; Humans ; In Vitro Techniques ; Inflammation ; Oxidative Stress ; Petroselinum ; Rutaceae ; Vegetables

Viriditoxin is a fungal metabolite isolated from Paecilomyces variotii, which was derived from the giant jellyfish Nemopilema nomurai. Viriditoxin was reported to inhibit polymerization of FtsZ, which is a key protein for bacterial cell division and a structural homologue of eukaryotic tubulin. Both tubulin and FtsZ contain a GTP-binding domain, have GTPase activity, assemble into protofilaments, two-dimensional sheets, and protofilament rings, and share substantial structural identities. Accordingly, we hypothesized that viriditoxin may inhibit eukaryotic cell division by inhibiting tubulin polymerization as in the case of bacterial FtsZ inhibition. Docking simulation of viriditoxin to beta-tubulin indicated that it binds to the paclitaxel-binding domain and makes hydrogen bonds with Thr276 and Gly370 in the same manner as paclitaxel. Viriditoxin suppressed growth of A549 human lung cancer cells, and inhibited cell division with G2/M cell cycle arrest, leading to apoptotic cell death.
Apoptosis* ; Cell Cycle Checkpoints* ; Cell Cycle* ; Cell Death ; Cell Division ; Eukaryotic Cells ; GTP Phosphohydrolases ; Humans* ; Hydrogen ; Lung Neoplasms* ; Lung* ; Paclitaxel ; Paecilomyces ; Polymerization ; Polymers ; Tubulin

No abstract available.
Fusariosis* ; Hand* ; Snake Bites* ; Wounds and Injuries*

BACKGROUND: Reactive oxygen species (ROS) play an important role in the induction of apoptosis under pathological conditions. Recently, a significant increase in ROS production and disrupted apoptosis mechanisms in keloids have been reported. Nuclear factor erythroid 2-related factor 2 (Nrf2) represents one of the most important cellular defense mechanisms against oxidative stress and is implicated in the regulation of apoptosis. Recently, it has been reported that Nrf2 upregulates Bcl-2, an anti-apoptotic protein. OBJECTIVE: To compare Nrf2 protein expression in normal skin tissues to keloid tissues. METHODS: ROS generation in keloid tissues was evaluated with OxyBlot analysis. Western blotting and/or immunohistochemical staining approaches were used to study expression of Nrf2 or Bcl-2 in keloid and normal skin tissues. Cellular fractionation was performed to examine subcellular distribution of Nrf2. Transfection of fibroblasts with Nrf2-specific small interfering RNA (siRNA) was conducted to understand the relationship between Nrf2 expression and apoptosis induction. RESULTS: Protein oxidation, a marker of oxidative stress, is increased in keloid tissues. Western blot analysis clearly showed that Nrf2 and Bcl-2 are downregulated in keloid tissues. Immunohistochemical staining of Nrf2 confirmed the results of the western blot analysis. Transfection of fibroblasts with the Nrf2-specific siRNA results in increased apoptosis and decreased cell viability. CONCLUSION: Collectively, our data indicate that Nrf2 expression is downregulated in keloid tissues, and that Nrf2 is involved in the development of apoptosis in Nrf2 siRNA-transfected fibroblasts. We propose that a defective antioxidant system and apoptotic dysregulation may participate in keloid pathogenesis.
Apoptosis ; Blotting, Western ; Cell Survival ; Defense Mechanisms ; Fibroblasts ; Keloid* ; NF-E2-Related Factor 2 ; Oxidative Stress ; Reactive Oxygen Species ; RNA, Small Interfering ; Skin* ; Transfection

BACKGROUND: Reactive oxygen species (ROS) play an important role in the induction of apoptosis under pathological conditions. Recently, a significant increase in ROS production and disrupted apoptosis mechanisms in keloids have been reported. Nuclear factor erythroid 2-related factor 2 (Nrf2) represents one of the most important cellular defense mechanisms against oxidative stress and is implicated in the regulation of apoptosis. Recently, it has been reported that Nrf2 upregulates Bcl-2, an anti-apoptotic protein. OBJECTIVE: To compare Nrf2 protein expression in normal skin tissues to keloid tissues. METHODS: ROS generation in keloid tissues was evaluated with OxyBlot analysis. Western blotting and/or immunohistochemical staining approaches were used to study expression of Nrf2 or Bcl-2 in keloid and normal skin tissues. Cellular fractionation was performed to examine subcellular distribution of Nrf2. Transfection of fibroblasts with Nrf2-specific small interfering RNA (siRNA) was conducted to understand the relationship between Nrf2 expression and apoptosis induction. RESULTS: Protein oxidation, a marker of oxidative stress, is increased in keloid tissues. Western blot analysis clearly showed that Nrf2 and Bcl-2 are downregulated in keloid tissues. Immunohistochemical staining of Nrf2 confirmed the results of the western blot analysis. Transfection of fibroblasts with the Nrf2-specific siRNA results in increased apoptosis and decreased cell viability. CONCLUSION: Collectively, our data indicate that Nrf2 expression is downregulated in keloid tissues, and that Nrf2 is involved in the development of apoptosis in Nrf2 siRNA-transfected fibroblasts. We propose that a defective antioxidant system and apoptotic dysregulation may participate in keloid pathogenesis.
Apoptosis ; Blotting, Western ; Cell Survival ; Defense Mechanisms ; Fibroblasts ; Keloid* ; NF-E2-Related Factor 2 ; Oxidative Stress ; Reactive Oxygen Species ; RNA, Small Interfering ; Skin* ; Transfection

PURPOSE: Although violence occurs frequently in Korean television dramas, its description or definition is unusual. Many studies have shown that TV dramas have a powerful effect on society and the violence shown in medical dramas helps in comprehension of hospital violence occurring in real life. Therefore, this study will cover the types and levels of violence. METHODS: We selected five recent Korean medical dramas. These five dramas, which consisted of 94 episodes and were broadcast from 2007 to 2011, are analyzed. Violence is limited to the occurrence inside the hospital; violence that occurs outside of the hospital is excluded. Media violence is analyzed within PAT (perpetrator-action-target). In addition, the violence levels and violence relationships are analyzed. RESULTS: Among the types of violence, 88.5% is verbal abuse, 3.5% is physical threat, and 8.0% is physical violence. In comparison of the violence relationship, violence between a doctor and a doctor forms the highest rate of 72.6%. In the level of violence, 0 level of violence caused by verbal abuse is the highest (88.5%); however, 5 level of violence level, which is death, is not observed. There are 1475 minutes of violence scenes from 6243 minutes, which is 23.6% of total time. CONCLUSION: Frequency of violence in Korean medical dramas is higher than that of normal dramas. Considering the powerful influence of the mass media, the violence of medical dramas should be controlled. To resolve the problem, the role of advisory doctors seems important.
Comprehension ; Drama ; Korea ; Mass Media ; Television ; Violence

OBJECTIVE: To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. METHOD: Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. RESULTS: There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05). CONCLUSION: Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.
Gait ; Humans ; Mobility Limitation ; Postural Balance ; Stroke

PURPOSE: To determine the effect of pelvic arch interference and the depth of the pelvic cavity, as shown on preoperative magnetic resonance imaging (MRI), on the performance of extraperitoneal laparoscopic radical prostatectomy (ELRP). MATERIALS AND METHODS: In 115 patients, pelvic bone images were obtained at the time of prostate MRI before ELRP. In the reconstructed sagittal plane, we measured the true conjugate diameter, the obstetric conjugate diameter, the difference between the true and obstetric diameters, and the distance between the true conjugate and the prostate apex (pelvic depth). We analyzed which factors were associated with operative time (OT), estimated blood loss (EBL), and positive surgical margins (PSMs). RESULTS: The difference between the true and obstetric conjugate diameters was 12.7+/-3.7 mm, and the pelvic depth was 59.9+/-6.0 mm. The OT, EBL, and the rate of PSMs were 260.1+/-91.1 minutes, 633.3+/-524.7 ml, and 19% (22/115), respectively. According to multiple linear regression analysis, predictors of a higher EBL included pelvic depth (3.0% higher per 1 mm increase in diameter difference, p=0.01) and prostate volume (1.5% higher per 1 cc increase in prostate volume, p=0.002). Factors associated with a longer OT were pelvic depth (p=0.04), serum prostate-specific antigen (p=0.04), prostate volume (p=0.02), and Gleason score (p=0.001). For PSMs, only pT2 was an independent factor. CONCLUSIONS: Our results suggest that the depth of the pelvic cavity and prostate volume may increase surgical difficulty in patients undergoing ELRP.
Humans ; Laparoscopy ; Linear Models ; Magnetic Resonance Imaging ; Neoplasm Grading ; Operative Time ; Pelvic Bones ; Prostate ; Prostate-Specific Antigen ; Prostatectomy

PURPOSE: To describe normal anatomy and compare the differences of external genital organs and urethra on MR imaging in pre- and postmenopausal women. MATERIALS AND METHODS: A total of 19 pre- and 18 postmenopausal healthy women underwent pelvis MR imaging at 1.5 T. Two radiologists retrospectively scored and compared the image quality of female external genitalia and urethra on axial T2-weighted images (T2WI) and axial fat-suppressed contrast-enhanced T1-weighted images (FSCE-T1WI) by using Wilcoxon signed ranks test. The radiologists compared the wall thickness or size of external genital organs and urethra on FSCE-T1WI between two groups by using Student t test. RESULTS: Image quality was better with FSCE-T1WI than with T2WI in all subjects (p < 0.05). The vestibular bulb, clitoris and labium minor were more clearly visualized on FSCE-T1WI in premenopausal subjects rather than in postmenopausal subjects (p < 0.05). The urethra had a target-like appearance with three layers in premenopausal and postmenopausal subjects. Postmenopausal subjects were observed to have significantly smaller vaginal wall thickness, urethral wall thickness and vestibular bulb width than premenopausal subjects (p < 0.05). CONCLUSION: The anatomy and morphologic changes of female external genital organs and urethra were well discernible on FSCE-T1WI.
Clitoris ; Female ; Genitalia ; Humans ; Pelvis ; Retrospective Studies ; Urethra