• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.46-66
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• 2018

Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

• Journal of Microbiology and Biotechnology
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• v.29 no.10
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• pp.1644-1655
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• 2019

Saccharomyces cerevisiae (S. cerevisiae) and glucagon-like peptide-2 (GLP-2) have been employed to improve the intestinal development of weaned animals. The goal of this study was to determine whether either exogenous S. cerevisiae or GLP-2 elicits major effects on fecal microbiotas and cytokine responses in weaned piglets. Ninety-six piglets weaned at 26 days were assigned to one of four groups: 1) Basal diet (Control), 2) empty vector-harboring S. cerevisiae (EV-SC), 3) GLP-2-expressing S. cerevisiae (GLP2-SC), and 4) recombinant human GLP-2 (rh-GLP2). At the start of the post-weaning period (day 0), and at day 28, fecal samples were collected to assess the bacterial communities via sequencing the V1-V2 region of the 16S-rRNA gene, and piglets' blood was also sampled to measure cytokine responses (i.e., IL-$1{\beta}$, TNF-${\alpha}$, and IFN-${\gamma}$). This study revealed that, on the one hand, although S. cerevisiae supplementation did not significantly alter the growth of weaned piglets, it induced increases in the relative abundances of two core genera (Ruminococcaceae_norank and Erysipelotrichaceae_norank) and decreases in the relative abundances of two other core genera (Lachnospiraceae_norank and Clostridiale_norank) and cytokine levels (IL-$1{\beta}$ and TNF-${\alpha}$) (p < 0.05, Control vs EV-SC; p < 0.05, rh-GLP2 vs GLP2-SC). On the other hand, GLP-2 supplementation had no significant influence on fecal bacterial communities and cytokine levels, but it produced better body weight and average daily gain (p < 0.05, Control vs EV-SC; p < 0.05, rh-GLP2 vs GLP2-SC). Therefore, altered fecal microbiotas and cytokine response effects in weaned piglets were due to S. cerevisiae rather than GLP-2.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.400-408
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• 2023

Objective : Nicotinamide mononucleotide adenylyl transferase 2 (NMNAT2) is a crucial factor for the survival of neuron. The role of NMNAT2 in damage following traumatic brain injury (TBI) remains unknown. This study was designed to investigate the role of NMNAT2 in TBI-induced neuronal degeneration and neurological deficits in rats. Methods : The TBI model was established in Sprague-Dawley rats by a weight-dropping method. Real-time polymerase chain reaction, western blot, immunofluorescence, Fluoro-Jade C staining, and neurological score analyses were carried out. Results : NMNAT2 mRNA and protein levels were increased in the injured-side cortex at 6 hours and peaked 12 hours after TBI. Knocking down NMNAT2 with an injection of small interfering RNA in lateral ventricle significantly exacerbated neuronal degeneration and neurological deficits after TBI, which were accompanied by increased expression of BCL-2-associated X protein (Bax). Conclusion : NMNAT2 expression is increased and NMNAT2 exhibits neuroprotective activity in the early stages after TBI, and Bax signaling pathway may be involved in the process. Thus, NMNAT2 is likely to be an important target to prevent secondary damage following TBI.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.210-217
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• 2018

Purpose: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. Materials and Methods: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. Results: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). Conclusion: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.

• Experimental and Molecular Medicine
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• v.50 no.12
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• pp.13.1-13.12
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• 2018

We aimed to explore whether changes in circulating levels of miRNAs according to type 2 diabetes mellitus (T2DM) or prediabetes status could be used as biomarkers to evaluate the risk of developing the disease. The study included 462 patients without T2DM at baseline from the CORDIOPREV trial. After a median follow-up of 60 months, 107 of the subjects developed T2DM, 30 developed prediabetes, 223 maintained prediabetes and 78 remained disease-free. Plasma levels of four miRNAs related to insulin signaling and beta-cell function were measured by RT-PCR. We analyzed the relationship between miRNAs levels and insulin signaling and release indexes at baseline and after the follow-up period. The risk of developing disease based on tertiles (T1-T2-T3) of baseline miRNAs levels was evaluated by COX analysis. Thus, we observed higher miR-150 and miR-30a-5p and lower miR-15a and miR-375 baseline levels in subjects with T2DM than in disease-free subjects. Patients with high miR-150 and miR-30a-5p baseline levels had lower disposition index (p = 0.047 and p = 0.007, respectively). The higher risk of disease was associated with high levels (T3) of miR-150 and miR-30a-5p ($HR_{T3-T1}=4.218$ and $HR_{T3-T1}=2.527$, respectively) and low levels (T1) of miR-15a and miR-375 ($HR_{T1-T3}=3.269$ and $HR_{T1-T3}=1.604$, respectively). In conclusion, our study showed that deregulated plasma levels of miR-150, miR-30a-5p, miR-15a, and miR-375 were observed years before the onset of T2DM and pre-DM and could be used to evaluate the risk of developing the disease, which may improve prediction and prevention among individuals at high risk for T2DM.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.3
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• pp.41-52
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• 2013

Purpose: This paper tries to set up the design guidelines for the 4 bedroom in Public Hospital wards as the standard multi-bed room in order to upgrade the bedroom environment, increase inpatients' and nurses' satisfaction level, and decrease cross infection possibility. Methods: Literature survey containing legal standards related to hospital bedrooms in Korea, Japan and Germany have been conducted. Questionnaires have been distributed to inpatients and nurses in 39 Public Hospital, and face to face talk with ward nurses in 9 Public Hospitals have been conducted. Thereafter 10 architectural drawings, 28 questionnaires from nurses and 544 questionnaires from inpatients have been analysed. Results: This article suggests some design guidelines and example drawings of standard 4 bedroom unit in Public Hospital. Implications: The result of this research would be useful as a reference when the architect tries to design a Four-bed room unit in Hospitals.

• Journal of Digestive Cancer Research
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• v.5 no.1
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• pp.37-43
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• 2017

Laparoscopic cholecystectomy is of one the most common general surgical operations performed today. Concomitant choledocholithiasis occurs in roughly 10-20% of patients with symptomatic gallstones. Laparoscopic bile duct exploration (LBDE) offers a single-stage minimally-invasive solution to the management of choledocholithiasis. LBDE may be performed either via the transcystic route or via laparoscopic choledochotomy. A number of strategies to improve success are available to the surgeon to help in the problem of complicated choledocholithiasis, these range from simple maneuvers to the use of laser or mechanical lithotriptors. With the advances in laparoscopic surgery, it is also possible to handle complex surgical conditions such as Mirizzi syndrome or recurrent pyogenic cholangitis laparoscopically, even though these have yet to be accepted as standard of care. Following laparoscopic choledochotomy, options for closure include: primary closure, closure over a T-tube, and closure over an endobiliary stent. T-tube placement has been associated with increased operating time and hospital length of stay compared to primary closure, with no significant differences in morbidity. Based on the available literature, LBDE appears comparable to ERCP with regards to procedural efficacy and morbidity. LBDE remains relevant to the general surgeon and is best viewed as being complementary to endoscopic therapy in the management of choledocholithiasis.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.387-391
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• 2013

Background The most common cutaneous malignant masses are basal cell carcinoma (BCC) and squamous cell carcinoma. The predominant site of a malignant mass is the face, which has many opportunities to be exposed to ultraviolet radiation. However the predilection sites of malignant masses have been equivocal due to the use of general regions, rather than anatomical landmarks, in surveys. A facial esthetic unit is an anatomical site classified as an area of similar facial contour characteristics that can be distinguished from other areas. The purpose of this study is to determine widely accepted anatomical landmarks using the esthetic unit. Methods We retrospectively analyzed 118 cases of malignant masses in our clinic from January 2005 to October 2012. We evaluated the patients' age, gender, and predilection site of the malignant mass by esthetic unit through pathology, medical records and patient photographs. We mapped the occurrence site of the malignant mass on schematic drawings of the esthetic units. Results Most of the malignant masses were BCC. The ratio of males to females was 1:1.41. The frequent predilection site of a malignant mass was on the nasal unit (33.1%), followed by the buccal unit (11.0%). Primary closure was the most common method of repairing a surgical defect (38.9%), followed by a local flap (35.5%). Conclusions This review described the relationship between clinical characteristics and esthetic units by proposing objective predilection sites for malignant masses, which can be used commonly as a framework in the study of malignant masses by unifying equivocal occurrence sites.

• Health Policy and Management
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• v.12 no.4
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• pp.34-55
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• 2002

In this study, the impact of organizational culture on the quality of social work services in hospitals were empirically analysed. A mailed questionnaire survey was conducted between February 19 and April 10, 2001. A sample of total 70 hospitals, including general hospitals with one social worker at least and single-department hospital with two social workers or more, were identified nationwide through the registry of Korean Association of Medical Social Workers and Korean Association of Hospitals. According to coping strategy and reacting pattern with the environmental changes, four types of organizational culture in each hospital, classified as group culture, developmental culture, hierarchial culture, and rational culture, were adopted for the independent variables. Three dimensional aspects of quality of social work service - structure, process, and outcome were selected as dependent variables in this study. Also the quality of social work service was distributed into provider-perceiving quality and consumer-perceiving quality The major findings were as following in summary; First, most social workers reported that the characteristic of culture in their hospitals are group culture the first, hierarchial culture the second, developmental culture the third, and rational culture finally in order of comparing the level of quality perceived between social worker's recognition. Second, service provider and consumer, The provider-perceiving quality showed less score than that of consumer, especially the lowest was the score of quality of outcome perceived by provider. Third, according to the types of organizational culture, there were significantly different levels of quality in total social work services, structure dimension and process dimension. The quality of outcome dimension did not show significant differences among the type of organizational culture. Finally, the most influential variables to the quality of social work service ice proved departmental form of social work unit, leader of social work unit, and developmental culture of hospital To assure quality services, accordingly, social work unit in hospital is required to be organized as a single unit, that means to be an independent department of which qualified social worker is supposed to control the unit. It is strongly recommended to develop leadership for the leaders of social work unit.

• Korean Journal of Digital Imaging in Medicine
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• v.3 no.1
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.