Background: In Korea, the safety culture is led by national policy. How the policy ensures a patient safety culture needs to be investigated. This study aimed to examine the way in which physicians and nurses regard, understand, or interpret the patient safety-related policy in the hospital setting. Methods: In this qualitative study, we conducted four focus group interviews (FGIs) with 25 physicians and nurses from tertiary and general hospitals in South Korea. FGIs data were analyzed using thematic analysis, which was conducted in an inductive and interpretative way. Results: Three themes were identified. The healthcare providers recognized its benefits in the forms of knowledge, information and training at least although the policy implemented by the law forcibly and temporarily. The second theme was about the interaction of the policy and the Korean context of healthcare, which makes a “turning point” in the safety culture.The final theme was about some strains and conflicts resulting from patient safety policy. Conclusion To provide a patient safety culture, it is necessary to develop a plan to improve the voluntary participation of healthcare professionals and their commitment to safety.Hospitals should provide more resources and support for healthcare professionals.

Mouse is a commonly used animal in life science studies and is classified as outbred if genetically diverse and inbred if genetically homogeneous. Outbred mouse stocks, are used in toxicology, oncology, infection and pharmacology research. The National Institute of Food and Drug Safety Evaluation (NIFDS; former the Korea National Institute of Health) have bred ICR mice for more than 50 years. We investigated to provide users with information and promote accountability to the Korl:ICR. To secure the indigenous data, biological characteristics of Korl:ICR were identified by comparing with other ICR stocks. This domestic ICR stock was denominated as ‘Korl:ICR’. Phylogenetic analysis using SNPs indicated that the population stratification of the Korl:ICR was allocated different area with other ICR. In addition, we measured litter size, body weight, body length, various organ weight, hematology and clinical blood chemistry of the Korl:ICR compared to other ICR. Otherwise, there are no significant differences among the biological phenotypes of Korl:ICR and other ICR. These results suggest that as a genetically indigenous source colony, the Korl:ICR is seperated (or independent) stock with other ICR. Also, we confirmed that there is no difference among the Korl:ICR and other ICR on biological phenotypes. Therefore, the Korl:ICR source colony might be a new stock in distinction from other ICR, it is a good milestone in securing ownership of the national laboratory animal resource. The NIFDS expects that the Korl:ICR mice will be useful animal resource for our domestic researchers.
Animals ; Animals, Laboratory ; Biological Science Disciplines ; Body Weight ; Chemistry ; Hematology ; Korea ; Litter Size ; Mice ; Mice, Inbred ICR ; Organ Size ; Ownership ; Pharmacology ; Phenotype ; Polymorphism, Single Nucleotide ; Population Characteristics ; Rodentia ; Social Responsibility ; Toxicology

Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer.
Adenocarcinoma* ; Aged* ; Cervix Uteri* ; Endometrium ; Fallopian Tubes ; Female ; Humans ; Ovary ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Uterus

BACKGROUND: Azacitidine (AZA) is standard care for patients with myelodysplastic syndrome (MDS) who have not had allogeneic stem cell transplantation. Chromosomal abnormalities (CA) including complex karyotype (CK) or monosomal karyotype (MK) are associated with clinical outcome in patients with MDS. METHODS: We investigated which prognostic factors including CAs would predict clinical outcomes in patients with International Prognostic Scoring System (IPSS) higher risk MDS treated with AZA, retrospectively. CK was defined as the presence of three or more numerical or structural CAs. MK was defined as the presence of two or more distinct autosomal monosomies or single autosomal monosomy with at least one additional structural CA. RESULTS: A total of 243 patients who treated with AZA, were enrolled. CK was present in 124 patients and MK was present in 90 patients. Bone marrow blasts > or =15% and CK were associated with poorer response (P=0.038, P=0.007) and overall survival (OS) (P<0.001, P<0.001) independently. Although MK in CK group was not associated with prognosis, non-MK status in non-CK group reflected favorable OS (P=0.005). The group including >3 CAs was associated with poorer OS (group including <3 CAs vs. only three CAs, P=0.001; group with >3 CAs vs. only three CAs, P=0.001). CONCLUSION: CK was an important prognostic parameter associated with worse outcome. MK may predict poor survival in only non-CK status. The higher number of CAs was associated with poorer survival.
Azacitidine* ; Bone Marrow ; Chromosome Aberrations ; Humans ; Karyotype* ; Monosomy ; Myelodysplastic Syndromes* ; Prognosis ; Retrospective Studies ; Stem Cell Transplantation

Achalasia is a primary esophageal motor disorder, which is a rare disease with an estimated prevalence of 0.5-1 per 100,000 general population. The typical symptoms are vomiting, dysphagia and weight loss, but the respiratory symptoms are often presented in the 20-30% of the patients. The respiratory symptoms are known to be caused by the regurgitation or aspiration of the undigested food. Choking, recurrent pneumonia nocturnal cough are common and bronchiectasis, lung abscess and atelectasis also have been reported. The treatment of achalasia aimed at improving esophageal peristalsis by reducing pressure at the lower esophageal sphincter. We experienced a case of esophageal achalasia coincidentally found in a 10-year-old girl who was admitted with the exacerbation of asthma. She had pneumatic dilatation and her asthma symptoms including nocturnal cough much improved.
Airway Obstruction ; Asthma ; Bronchiectasis ; Child ; Cough ; Deglutition Disorders ; Dilatation ; Esophageal Achalasia ; Esophageal Sphincter, Lower ; Humans ; Lung Abscess ; Peristalsis ; Pneumonia ; Prevalence ; Pulmonary Atelectasis ; Rare Diseases ; Vomiting ; Weight Loss

BACKGROUND AND OBJECTIVES: Resveratrol (trans-3, 4', 5-trihydroxy-stilbene), a naturally occurring polyphenolic phytoalexin found abundantly in grape skins and red wines, has been reported to protect heart cells from ischemia/reperfusion (I/R) injury through its significant antioxidant properties. Apoptosis of cardiac myocytes is also involved in several cardiovascular diseases, but it remains unknown whether the protective effects of resveratrol in hypoxic myocardial cell injury are mediated via suppression of apoptosis. In this study, we investigated whether resveratrol confers cardioprotection against hypoxia via anti-apoptosis in a hypoxic model of cultured H9c2 cardiomyoblasts. MATERIALS AND METHODS: H9c2 cardiomyoblasts were obtained from the Korean Cell Line Bank. The cultured cells were divided into four groups: a normal control group, a hypoxia group, a group treated with resveratrol (10 microgram/mL) before hypoxic insult, and a group treated with resveratrol (10 microgram/mL) after hypoxic insult. The control group was placed in 5% CO2 incubators, and the hypoxia and resveratrol-treated groups were placed in 1% O2 incubators. Apoptosis was assayed by cytological analysis with Western blotting and real-time PCR for Bcl-2, Bax, and caspase-3. RESULTS: The expression of Bcl-2 was significantly decreased in the hypoxia group compared with the control group, and resveratrol treatment inhibited the hypoxia-induced decline of Bcl-2 in hypoxic myocardial cells. Conversely, the expressions of Bax and caspase-3 were significantly increased in the hypoxia group, while resveratrol inhibited the hypoxia-induced increase of Bax and caspase. In addition, hypoxia significantly increased the ratio of Bax/Bcl-2 expression, but it was significantly decreased in the resveratrol-treated group. CONCLUSION: The present study demonstrates that the cardioprotective effects of resveratrol in hypoxic injury are mediated via the mechanisms of anti-apoptosis.
Anoxia ; Apoptosis ; bcl-2-Associated X Protein ; Blotting, Western ; Cardiovascular Diseases ; Caspase 3 ; Cell Line ; Cells, Cultured ; Heart ; Incubators ; Myocytes, Cardiac ; Real-Time Polymerase Chain Reaction ; Skin ; Vitis ; Wine

Pituitary adenylate cyclase activating polypeptide (PACAP) was first isolated from ovine hypothalamus and was known to stimulate the release of growth factor in various cells. Recently, we reported the cellular localization of PACAP and its type I (PAC1 ) receptor in rat placenta during pregnancy. Placenta is a critical organ that synthesizes several growth factors and angiogenic factors for the fetal development and its own growth. However, there is little information regarding the cellular localization of PACAP and its receptor in human placenta at various gestations. The aim of the present study was to define the expression and distribution of PACAP and PAC1 receptor mRNAs in the human placenta during the pregnancy period. PACAP and PAC1 receptor mRNAs were expressed in stroma cells of stem villi and terminal villi. At the early stage, on 7 and 14 weeks, PACAP and PAC1 receptor genes were moderately expressed in stroma cells surrounding the blood vessels within stem villi. These genes were strongly expressed in stroma cells of stem villi and terminal villi on 24 and 38 weeks. The expression of these genes was increased as gestation advanced, and localized in the same areas. Localization of PACAP and PAC1 receptor demonstrate the evidence that PACAP may play an important role, as an autoregulator or pararegulator via its PAC1 receptor. In conclusion, our findings strongly suggest that PACAP may have a critical role in physiological function of the placenta for gestational maintenance and fetal growth.
Chorionic Villi/metabolism ; Female ; Gene Expression ; Humans ; Nerve Growth Factors/*biosynthesis ; Neuropeptides/*biosynthesis ; Neurotransmitter Agents/*biosynthesis ; Pituitary Adenylate Cyclase-Activating Polypeptide ; Placenta/*metabolism ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; RNA, Messenger ; Receptors, Cell Surface/*biosynthesis ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide ; Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I

INTRODUCTION: Diffuse interstitial lung diseases (DILD) comprise of a large group of lung diseases with diverse etiologies. They are classified into four categories based on the etiology and pathological findings. In Korea, epidemiological data on DILD has never been reported in a prospective manner. METHOD: From May 2002 to April 2004, total 487 patients with DILD were prospectively registered at Samsung Medical Center. The prospective observational analysis of the etiologies, its classification based on 2002 ATS/ERS (American Thoracic Society/European Respiratory Society) guidelines, as well as diagnostic tests and the retrospective analysis of the treatment modalities were carried out. Any infectious and malignant causes were excluded. RESULTS: 1) The patients were classified into idiopathic interstitial pneumonia (IIP) in 269 patients (55.2%), known causes of DILD in 168 patients (34.5%), sarcoidosis in 27 patients (5.5%), other forms of DILD in 14 patients (2.9%), and undetermined DILD in 9 patients (1.9%). 2) The diagnostic test showed that most patients had undergone chest high resolution computed tomography (HRCT) and pulmonary function test (PFT) (97%, 89%). Transbronchial lung biopsy (TBLB) and surgical lung biopsy (SLB) were performed in limited patients (38%, 29%). 3) Among 269 patients with IIP, 220 (82%) had idiopathic pulmonary fibrosis (IPF) while 23 (9%) had nonspecific interstitial pneumonia. SLB was carried out in 36% of patients with IIP. 4) Symptomatic supportive care was given to 67% of IPF, but specific medical treatment including corticosteroids was administered to 89% of non-IPF patients. CONCLUSION: A nationwide registry of DILD patients is required to determine the annual incidence, etiology, and practice pattern of diagnosis and treatment in Korea.
Adrenal Cortex Hormones ; Biopsy ; Classification ; Diagnosis ; Diagnostic Tests, Routine* ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Incidence ; Korea ; Lung ; Lung Diseases ; Lung Diseases, Interstitial ; Respiratory Function Tests ; Retrospective Studies ; Sarcoidosis ; Thorax

PURPOSE: To classify the type of transient synovitis and determine a treatment plan using MRI. MATERIALS AND METHODS: From March 1985 to October 1998, 37 hips in 33 children with clinical symptoms of transient synovitis were evaluated with MRI. The average age of the patients was 7.5 years (range, 3.5-15 years) . The mean follow-up period was 18 months (range, 12-36 months) . The 37 hips were classified as grade l, ll, lll, or lV according to the amount of accumulated joint fluid on MRI. RESULTS: Of 37 hips with transient synovitis, 36 hips had no involvement of epiphysis and metaphysis and one hip had a cyst and bone marrow edema in the metaphysis on MRI scans. The amount of joint fluid was classified as seen on MRI scans: grade 1 in 2 hips, grade 2 in 14 hips, grade 3 in 5 hips, and grade 4 in 16 hips. CONCLUSION: MRI is a very useful diagnostic tool to classify and determine the treatment plan for transient synovitis. In patients with grade 3 and 4 joint fluid, the risk of vascular compromise of the femoral epiphysis could be higher. These patients should be hospitalized and immobilized in flexed position of the hip. Patients with grade 1 and 2 joint fluid can be treated at home with immobilization.
Bone Marrow ; Child ; Classification* ; Edema ; Epiphyses ; Follow-Up Studies ; Hip ; Humans ; Immobilization ; Joints ; Magnetic Resonance Imaging* ; Synovitis*

STUDY DESIGN: A retrospective study was designed to evaluate the clinical result and difference between short segment and long segment fixation, which was undertaken by posterior approach for thoracic and lumbar spine fractures. OBJECTIVE: To determine and compare the mechanical maintenance and ability of correction, and clinical and neurologic recov-ery between short segment and long segment fusion group. SUMMARY OF BACKGROUND DATA: The long segment instrumentation is a cause of decrease of motion segment in thoracic and lumbar spine. In short segment fusion, screw failures were reported. MATERIALS AND METHODS: From 1989 thorough 1997, 54 patients who had been operated on by the posterior approach with transpedicular screw fixation for spine injuries were divided into two groups. The authors applied the short segment transpedic-ular instrumentation including fractured vertebra. Short segment group included 35 cases, and long segment group, 19 cases. The mean follow-up period was one year and eight months for short segment group, two years and seven months for long segment one. The results were evaluated by comparing the anterior vertebral height, sagittal index in simple roentgenogram and neurologic recovery. RESULTS: The average of anterior vertebral height which was 50.7% at preoperation, became 78.7% after the operation and measured 74.9% at final follow-up in long segment fusion group, while in short segment fusion group it was 59.7%, 79.3% and 77.7%, respectively. The average of sagittal index of 17.5degreeat preoperation became 6.7degreeafter the operation, and measured 8degreeat final follow-up in long segment fusion group, while in short segment fusion group it was 19.9degree, 10.4degree, and 12.1degree, respectively. Overall clinical results had no statistical significant difference between two groups. Of the thirty-six patients with neurologic deficits, twenty-two improved by over the one Frankel grade. CONCLUSIONS: The authors conclude that the short segment transpedicular instrumentation including fractured vertebra is a successful method of thoracolumbar and lumbar burst fractures.
Follow-Up Studies ; Humans ; Neurologic Manifestations ; Retrospective Studies ; Spine