PURPOSE: To compare the survival of corneal grafts and the changes in endothelial cell density in penetrating keratoplasty using domestic or imported corneas. METHODS: Medical records of 236 eyes of 211 patients who underwent penetrating keratoplasty from November 2004 to August 2011 in Seoul National University Hospital and were followedup at least 1 year were retrospectively reviewed. After excluding the patients who received the combined surgeries with other surgeries except cataract surgery, the eyes were divided into 2 groups depending on the origin of donor tissue resulting in a domestic cornea group (108 eyes) and an imported cornea group (128 eyes). Recipient demographics, preoperative diagnosis, donor age, death-to-preservation time, death-to-operation time and pre-and postoperative visual acuities were compared between the 2 groups. Kaplan-Meier survival and changes in endothelial cell density were analyzed at 3, 6 and 12 months and then every year. RESULTS: The most common preoperative diagnoses were regraft and corneal opacity in the domestic and imported cornea groups, respectively, without statistical difference. Death-to-preservation time was 8.9 hours and 8.0 hours in the domestic and imported cornea groups, respectively, without statistical difference. However, death-to-operation time was longer in the imported cornea group (4.98 days) than in the domestic cornea group (2.18 days). There were no differences in pre- and postoperative visual acuities, decrease in annual changes in endothelial densities and survival up to 3 years between the 2 groups. In addition, the survival and decreased annual changes in endothelial densities were not different from each other in penetrating keratoplasty combined with cataract surgery or in penetrating keratoplasty for a corneal edema. CONCLUSIONS: Our study results suggest that clinical outcomes of the penetrating keratoplasty using imported corneas are comparable in efficacy when compared with the clinical outcomes using domestic corneas.
Cataract ; Cornea* ; Corneal Edema ; Corneal Opacity ; Demography ; Diagnosis ; Endothelial Cells ; Humans ; Keratoplasty, Penetrating* ; Medical Records ; Retrospective Studies ; Seoul ; Tissue Donors ; Transplants ; Visual Acuity

PURPOSE: This study investigated interleukin (IL)-17-secreting cell involvement in sterile inflammation, and evaluated the effect of mesenchymal stem cells (MSCs) on IL-17-secreting cell immunologic profiling. METHODS: Twenty mice were sacrificed at time points of 6 hours, 1 day, 1 week, and 3 weeks (each group, n = 5) after the cornea was chemically injured with 0.5N NaOH; IL-17 changes in the cornea were evaluated using enzyme-linked immunosorbent assay. Further, IL-17 secreting cells were assessed in the cervical lymph nodes by a flow cytometer. Rat MSCs were applied intraperitoneally in a burn model (n = 10), IL-17-secreting T helper 17 (Th17) cell and non-Th17 cell changes were checked using a flow cytometer in both cornea and cervical lymph nodes at 1week, and compared with those in the positive control (n = 10). RESULTS: IL-17 was highest in the cornea at 1 week, while, in the cervical lymph nodes, IL-17-secreting cells showed early increase at 6 hours, and maintained the increase through 1 day to 1 week, and levels returned to the basal level at 3 weeks. Specifically, the non-Th17 cells secreted IL-17 earlier than the Th17 cells. When the MSCs were applied, IL-17 secretion was reduced in CD3(+)CD4(-)CD8(-), CD3(+)CD4(+)CD8(-), and CD3(+) CD4(-)CD8(+) cells of the cervical lymph nodes by 53.7%, 43.8%, and 50.8%, respectively. However, in the cornea, IL-17 secretion of CD3(+)CD4(-)CD8(-) cells was completely blocked. CONCLUSIONS: The results indicated that both IL-17-secreting non-Th17 and Th17 cells were involved in the chemical burn model, and MSCs appeared to mainly modulate non-Th17 cells and also partially suppress the Th17 cells.
Animals ; Burns, Chemical/*immunology/metabolism/pathology ; Cells, Cultured ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eye Burns/*immunology/metabolism/pathology ; Flow Cytometry ; *Immunity, Cellular ; Interleukin-17/*secretion ; Male ; Mesenchymal Stromal Cells/immunology/pathology/*secretion ; Mice ; Mice, Inbred C57BL

BACKGROUND AND OBJECTIVES: To prevent getting wrong information and improve high quality of life, it is necessary to provide accurate information and patient education. This study aimed to collect basic data and develop educational program for thyroid cancer patient by understanding their educational needs. MATERIALS AND METHODS: Between April 16 and June 15, 2012, 159 patients who underwent thyroid cancer surgery were enrolled. This survey consisted of 5 areas including management of the symptom and the complication after surgery, postoperative wound and dietary management, treatment plan after discharge, medication management, and daily life. RESULTS: The most common way for the patients to acquire information about the disease was Internet and the patients who used INTERNET as their information source were 54.7%. Doctors (76.1%) and nurses (21.4%) were the preferred educators for the patients, and small group education was the preferred education method. Specifically the need for "management of the symptom and the complication after surgery" was the highest (3.33), followed by "treatment plan after discharge" (3.31), "medication management" (3.19), "postoperative wound and dietary management" (3.17). CONCLUSION: Medical team including doctors and nurses should be the center to activate small group education for patients. Professional and individualized education program should be developed to give the proper education to patients and their family.
Education ; Health Surveys ; Humans ; Internet ; Methods ; Patient Education as Topic ; Quality of Life ; Thyroid Gland* ; Thyroid Neoplasms* ; Wounds and Injuries

No abstract available.
Child ; Choledochal Cyst ; Humans

PURPOSE: To report the clinical outcomes of total corneolimbal transplantation in two cases. CASE SUMMARY: One patient, who previously underwent three rounds of penetrating keratoplasty and limbal transplantation for uncontrollable peripheral and central corneal melting, received total corneolimbal transplantation. The other patient who underwent penetrating keratoplasty with limbal transplanation for a chemical burn and who did not experience corneal perforation also received total corneolimbal transplantation. During the average 19 months of follow-up, cyclophotocoagulation was performed to control high intraocular pressure in both patients. Both eyes were tectonically maintained without further corneal destruction despite poor visual acuity and rejection. CONCLUSIONS: Total corneolimbal transplantation may be an effective tectonic procedure for corneal melting. This procedure can be considered as another option for patients with corneal melting after failed limbal and corneal transplantation.
Burns, Chemical ; Corneal Perforation ; Corneal Transplantation ; Eye ; Follow-Up Studies ; Freezing ; Humans ; Intraocular Pressure ; Keratoplasty, Penetrating ; Transplants ; Visual Acuity

PURPOSE: The glutathione-S-transferase (GST)P1, GSTM1, and GSTT1 genotypes have been associated with an increased risk of prostate, bladder, and lung cancers. The aim of this study was to investigate the association between the GSTP1, GSTM1, and GSTT1 genotypes and the risk of prostate cancer in Korean men. MATERIALS AND METHODS: The study group consisted of 166 patients with histologically confirmed prostate cancer. The control group consisted of 327 healthy, cancer-free individuals. The diagnosis of prostate cancer was made by transrectal ultrasound-guided biopsy. Patients with prostatic adenocarcinoma were divided into organ-confined (< or =pT2) and non-organ-confined (> or =pT3) subgroups. The histological grades were subdivided according to the Gleason score. The GSTP1, GSTM1, and GSTT1 genotypes were determined by using polymerase chain reaction-based methods. The relationship among GSTP1, GSTM1, and GSTT1 polymorphisms and prostate cancer in a case-control study was investigated. RESULTS: The frequency of the GSTM1 null genotype in the prostate cancer group (54.2%) was higher than in the control group (odds ratio=1.53, 95% confidence interval=1.20-1.96). The comparison of the GSTP1, GSTM1, and GSTT1 genotypes and cancer prognostic factors, such as staging and grading, showed no statistical significance. CONCLUSIONS: An increased risk for prostate cancer may be associated with the GSTM1 null genotype in Korean men, but no association was found with the GSTT1 or GSTP1 genotypes.
Adenocarcinoma ; Biopsy ; Case-Control Studies ; Genotype ; Glutathione Transferase ; Humans ; Lung Neoplasms ; Male ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms ; Urinary Bladder

PURPOSE: Many patients with early stage breast cancer are currently being treated with both adjuvant chemotherapy (CT) and radiotherapy (RT). We performed this study to assess the toxicity of concurrent adjuvant cyclophosphamide, methotrexate, and 5-fluourouracil (CMF) CT and RT for treating early breast cancer patients. METHODS: Between January 2000 and December 2005, 97 patients with stage I or II invasive breast carcinoma were treated with breast-conserving surgery, and they received 6 monthly cycles of classic oral chemotherapy with CMF. Within day 7 of cycle 1, the patients started 3 dimensional conformal RT (3DCRT) with a stadard dose, followed by a boost. We used the Common Terminology Criteria for Adverse Events v 3.0 to score the level of acute toxicity for CT. The adverse effects of RT were graded according to the Radiation Therapy Oncology Group criteria. RESULTS: The mean age of the patients was 45.8 yr (range:30-64). The most common toxicity was nausea and leukopenia. The dose of chemotherapy was reduced to 80% of the planned dose for 6.2% of the patient. CT was disrupted for 4.1% of the patients. RT was not disrupted for any patient. Grade 3 and 4 neutropenia occurred in 41 (42.3%) patients, but only one patient needed hospitalization due to fever. Grade 3 skin lesions developed during or shortly after RT in 10.7% of the patients. Radiation penumonitis was noted in 15.5% of the patients. The median follow-up time was 38 months. There was no local recurrence and 2 (2.08%) distant metastases during follow-up. CONCLUSION: From the results of our study, we conclude that the concurrent administration of adjuvant CMF CT and RT is associated with a low risk of serious toxicity and this is an acceptable adjuvant regimen for patients with early stage breast cancer.
Breast Neoplasms* ; Breast* ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Drug Therapy* ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Leukopenia ; Mastectomy, Segmental ; Methotrexate ; Nausea ; Neoplasm Metastasis ; Neutropenia ; Radiotherapy* ; Recurrence ; Skin

PURPOSE: The purpose of this study was to identify motivational factors that may influence health behaviors of patients with coronary artery disease. METHODS: Structured questionnaires were used with a convenience sample of 164 subjects who were discharged from the hospital. The subjects were recruited for an interview at outpatient clinic in hospitals. The tools for the study were the motivational factors and health behaviors measure for the Elderly with cardiovascular disease. The data were analyzed using frequency, t-test, ANOVA, sheffe, Pearson correlation coefficient and stepwise multiple regressions. RESULTS: There were significant correlations between motivational factors and health behaviors, ranging from r=.192 to .692. Stepwise multiple regression analyses indicated that 51% of variance in health behaviors was explained by self-efficacy and perceived benefits among four motivational factors(F=34.988, p<.01). Self-efficacy contributed the greatest amount of variance in health behaviors(beta=.467), followed by perceived benefits(beta=.235). CONCLUSIONS: The results of the study indicate that motivation, especially self-efficacy, was very important in predicting health behaviors of patients with coronary artery disease. Thus it would be necessary to include motivational factors in designing rehabilitation program for people with coronary artery disease.
Aged ; Ambulatory Care Facilities ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Health Behavior* ; Humans ; Motivation ; Surveys and Questionnaires ; Rehabilitation

PURPOSE: Concept analysis is an essential part of theory development in nursing. Thus, many strategies or methods of concept analysis have been suggested in nursing literature. However, in Korea, only limited strategies were utilized, without much consideration on a wide range of strategies in choosing a method that coincides with the characteristics of each concept to analyze. The purpose of this article was to propose various strategies for concept analysis. METHOD: A literature review method was used. RESULT: Ten methods of concept analysis were identified in the literature, and they were evaluated for advantages and limitations. In addition to the method by Walker and Avant and a hybrid model, more advanced strategies, such as triangulation method, critical analysis and the feminist approach were introduced and described in detail. The examples used in each concept analysis method were presented in table to provide the extent of utilization of each method. CONCLUSION: This article provides a wide range of strategies in identifying, clarifying, or elaborating a concept. It might help in choosing a method that best fits the concept to analyze, thus enhancing quality of concept analysis research.
*Concept Formation ; Data Interpretation, Statistical ; Humans ; *Nursing Theory ; Research Design

Inguinal hernia is the most common disease treated by the pediatric surgeon. There are several controversial aspects of management 1)the optimal timing of surgical repair, especially for preterm babies, 2)contralateral groin exploration during repair of a clinically unilateral hernia, 3)use of laparoscope in contralateral groin exploration, 4)timing of surgical repair of cord hydrocele, 5)perioperative pain control, 6)perioperative management of anemia. In this survey, we attempted to determine the approach of members of KAPS to these aspects of hernia treatment. A questionnaire by e-mail or FAX was sent to all members. The content of the questionnaire were adapted from the "American Academy of Pediatrics (AAP) Section on Surgery hernia survey revisited (J Pediatr Surg 40, 1009-1014, 2005)". For full-term male baby, most surgeons (85.7 %) perform an elective operation as soon as diagnosis was made. For reducible hernia found in ex-preterm infants already discharged from the neonatal intensive care unit (NICU), 76.2 % of surgeons performed an elective repair under general anesthesia (85.8 %). 42.9 % of the surgeons performed the repair just before discharge. For same-day surgery for the ex-premature baby, the opinion was evenly divided. For an inguinal hernia with a contralateral undescended testis in a preterm baby, 61.9 % of surgeons choose to 'wait and see' until 12 month of age. The most important consideration in deciding the timing of surgery of inguinal hernia in preterm baby was the existence of bronchopulmonary dysplasia (82.4 %), episode of apnea/bradycardia on home monitoring (70.6 %). Most surgeons do not explore the contralateral groin during unilateral hernia repair. Laparoscope has not been tried. Most surgeons do not give perioperative analgesics or blood transfusion.
Analgesics ; Anemia ; Anesthesia, General ; Blood Transfusion ; Bronchopulmonary Dysplasia ; Child* ; Cryptorchidism ; Diagnosis ; Electronic Mail ; Groin ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea* ; Laparoscopes ; Male ; Pediatrics ; Surveys and Questionnaires