Background/Aims: Irreversible electroporation (IRE) is a relatively new ablation method. However, the application of IRE ablation in the treatment of biliary disease has not been attempted. A minimally invasive approach using endoscopic retrograde cholangiopancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we aimed to investigate the feasibility of endoscopic IRE for the biliary tract using an animal model. Methods: A new catheter-type electrode was developed for endoscopic IRE ablation of the biliary tract. We performed ERCP and endoscopic IRE ablations in the normal common bile duct of Yorkshire pigs. The experimental setting of IRE was 500 V/cm (50 pulses, 100-µs length). The animals were sacrificed after 24 hr, and the ablated bile duct was examined. Results: Well-demarcated focal color changes were observed on the mucosa of the common bile duct. The depth of change after IRE was confined to the mucosal and submucosal layers. Apoptotic changes in the bile duct were observed only around the IRE ablation area. Immunohistochemistry assay showed cell death in the bile duct along the electrode. Conclusions Endoscopic IRE ablation using ERCP was successfully performed in the common bile duct. It can be a potential option for the treatment of biliary tumors.

Purpose: This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation. Methods: The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis. Results: The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001). Conclusion It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.

Purpose: This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation. Methods: The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis. Results: The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001). Conclusion It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.

Background/Aims: Irreversible electroporation (IRE) is a relatively new ablation method. However, the application of IRE ablation in the treatment of biliary disease has not been attempted. A minimally invasive approach using endoscopic retrograde cholangiopancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we aimed to investigate the feasibility of endoscopic IRE for the biliary tract using an animal model. Methods: A new catheter-type electrode was developed for endoscopic IRE ablation of the biliary tract. We performed ERCP and endoscopic IRE ablations in the normal common bile duct of Yorkshire pigs. The experimental setting of IRE was 500 V/cm (50 pulses, 100-µs length). The animals were sacrificed after 24 hr, and the ablated bile duct was examined. Results: Well-demarcated focal color changes were observed on the mucosa of the common bile duct. The depth of change after IRE was confined to the mucosal and submucosal layers. Apoptotic changes in the bile duct were observed only around the IRE ablation area. Immunohistochemistry assay showed cell death in the bile duct along the electrode. Conclusions Endoscopic IRE ablation using ERCP was successfully performed in the common bile duct. It can be a potential option for the treatment of biliary tumors.

Background: The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. Methods: This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. Results: Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53%) and infection (44%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. Conclusions Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6–11 years in the 6th KNHANES (2013–2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ≥ 200 mL/day significantly increased by 1.83 times (95% CI, 1.11–3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35–4.33) and boys (3.15 times; 95% CI, 1.53–6.49) with carbonated beverage intake of ≥ 200 mL/day when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.
Beverages* ; Carbohydrates ; Carbonated Beverages ; Child* ; Coffee ; Confounding Factors (Epidemiology) ; Fruit ; Humans ; Korea* ; Methods ; Nutrition Surveys* ; Obesity* ; Odds Ratio ; Pediatric Obesity ; Tea ; Vegetables

Maternal hyperthermia, which is currently confirmed as one of major causative factors inducing growth retardation, congenital anomalies and abortion, is known to influence normal development of CNS and various organ system. In addition, maternal hyperthermia could induce severe developmental defects including development of the limb. However, it is not clearly identified how maternal hyperthermia affects the expression of chondrogenesis-related proteins in developing limb of mouse. Thus, this study is aimed to investigate the effects of the maternal hyperthermia on the expression of a various proteins in developing upper limb. To elucidate it, ICR mice were used in this study, and the animals were divided into control and heat shock groups. The heat shock treatment was given to embryonic day (ED) 8. The animals were sacrificed on ED 11, 13, 15 and 17, and the humerus were removed. Chondrogenesis-related factors such as FGF8, SOX9 and collagen II were detected on ED 11, 13 and 15 using western blot and immunohistochemistry. Developing humerus on ED 17 was stained with alizarin red S and alcian blue. The expression of FGF8 of heat shock groups was continued even though the development was succeeded. SOX9 expression in heat shock groups was significantly elevated on ED 13 compared to the control embryos. In addition, collagen II expression of heat groups was significantly higher than that of the control group on ED 13 and 15. The results of this study suggest that hyperthermia causes delayed endochondral ossification in long bone through continuous expression of FGF8, SOX9 and collagen II proteins even though the endochondral ossification is succeeded.
Animals ; Anthraquinones ; Blotting, Western ; Collagen ; Embryonic Structures ; Extremities ; Fever ; Hot Temperature ; Humerus ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Osteogenesis ; Proteins ; Shock

Maternal hyperthermia, which is currently confirmed as one of major causative factors inducing growth retardation, congenital anomalies and abortion, is known to influence normal development of CNS and various organ system. In addition, maternal hyperthermia could induce severe developmental defects including development of the limb. However, it is not clearly identified how maternal hyperthermia affects the expression of chondrogenesis-related proteins in developing limb of mouse. Thus, this study is aimed to investigate the effects of the maternal hyperthermia on the expression of a various proteins in developing upper limb. To elucidate it, ICR mice were used in this study, and the animals were divided into control and heat shock groups. The heat shock treatment was given to embryonic day (ED) 8. The animals were sacrificed on ED 11, 13, 15 and 17, and the humerus were removed. Chondrogenesis-related factors such as FGF8, SOX9 and collagen II were detected on ED 11, 13 and 15 using western blot and immunohistochemistry. Developing humerus on ED 17 was stained with alizarin red S and alcian blue. The expression of FGF8 of heat shock groups was continued even though the development was succeeded. SOX9 expression in heat shock groups was significantly elevated on ED 13 compared to the control embryos. In addition, collagen II expression of heat groups was significantly higher than that of the control group on ED 13 and 15. The results of this study suggest that hyperthermia causes delayed endochondral ossification in long bone through continuous expression of FGF8, SOX9 and collagen II proteins even though the endochondral ossification is succeeded.
Animals ; Anthraquinones ; Blotting, Western ; Collagen ; Embryonic Structures ; Extremities ; Fever ; Hot Temperature ; Humerus ; Immunohistochemistry ; Mice ; Mice, Inbred ICR ; Osteogenesis ; Proteins ; Shock

BACKGROUND/AIMS: Since endoscopes are reusable apparatus classified as semicritical item, thorough reprocessing to achieve high-level disinfection is of utmost importance to prevent spread of infection. To improve disinfection efficacy and safety, disinfectants and endoscope reprocessors are continuously evolving. This study aimed to compare the efficacy of the combination of polyhexamethylenebiguanide hydrochloride-alkyldimethylbenzylammonium chloride (PHMB-DBAC) and orthophthalaldehyde (OPA) used respectively in ultrasonographic cleaning incorporated automated endoscope reprocessors: COOLENDO (APEX Korea) or OER-A (Olympus Optical). METHODS: A total of 86 flexible upper endoscopes were randomly reprocessed with either COOLENDO/PHMB-DBAC or OER-A/OPA. Culture samplings were done at two sites (endoscope tip and working channel) which were later incubated on blood agar plate. Bacterial colonies were counted and identified. RESULTS: The culture-positive rate at the endoscope tip and working channel was 0% and 2.33% for COOLENDO/PHMB-DBAC and 4.65% and 0% for OER-A/OPA. Staphylococcus hominis was cultured from one endoscope reprocessed with COOLENDO/PHMB-DBAC and Pseudomonas putida was isolated from two endoscopes reprocessed with OER-A/OPA. CONCLUSIONS: The reprocessing efficacy of COOLENDO/PHMB-DBAC was non-inferior to that of OER-A/OPA (p=0.032; confidence interval, -0.042 to 0.042). During the study period, significant side effect of PHMB-DBAC was not observed.
Agar ; Disinfectants ; Disinfection ; Endoscopes ; Pseudomonas putida ; Staphylococcus hominis

PURPOSE: The purpose of this study was to analyze intervention studies related to Snoezelen (multisensory environment). METHODS: Studies related to Snoezelen (multisensory environment) published between 1995 and 2010 in both Korean and International journals were systematically reviewed, and analyzed following guidelines. Based on inclusion criteria, 23 studies including 5 Korean and 18 International articles were selected. RESULTS: Most studies were conducted in various area of research such as medicine, nursing, and occupational therapy. There was no publication related to Snoezelen (multisensory environment) in Korean nursing journals. In terms of target population, more than 65% of the study subjects were patients with dementia, mental retardation, and learning disability. Intervention was implemented mostly in less than 30 minutes, once a week for 2 to 4 weeks. The effects on behavior, physical, and psychological contexts were assessed as outcome indicators. There was more 'positive' than 'no effect' in self-stimulatory behaviors, problem behaviors, heart rate, pain, mood state, and anxiety, whereas more 'no effect' than 'positive' in blood pressure, respiration, enjoyment, and relaxation. CONCLUSION: Future studies are needed to develop the protocol and outcome indicators for effective use of this new intervention in Korea.
Anxiety ; Blood Pressure ; Dementia ; Health Services Needs and Demand ; Heart Rate ; Humans ; Intellectual Disability ; Clinical Trial ; Korea ; Learning Disorders ; Occupational Therapy ; Publications ; Respiration