Publications by authors named "Ji Yeon Lee"

425 Publications

Characterization of the A-Type potassium current in murine gastric fundus smooth muscles.

Am J Physiol Cell Physiol 2021 08 25. Epub 2021 Aug 25.

Department of Physiology and Cell Biology, University of Nevada Reno School of Medicine, Reno, NV, United States.

Transient outward, or "A-type" currents are rapidly inactivating voltage gated potassium currents that operate at negative membrane potentials. A-type currents have not been reported in the gastric fundus, a tonic smooth muscle. We used whole-cell voltage-clamp to identify and characterize A-type currents in smooth muscle cells (SMCs) isolated from murine fundus. A-type currents were robust in these cells with peak amplitudes averaging 1.5nA at 0 mV. Inactivation was rapid with a time constant of 71ms at 0 mV; recovery from inactivation at -80 mV was similarly rapid with a time constant of 75ms. A-type currents in fundus were blocked by 4-aminopyridine (4-AP), flecainide and phrixotoxon-1 (PaTX1). Remaining currents after 4-AP and PaTX1 displayed half-activation potentials that were shifted to more positive potentials and showed incomplete inactivation. Currents after TEA displayed half inactivation at -48.1±1.0 mV. Conventional microelectrode and contractile experiments on intact fundus muscles showed that 4-AP depolarized membrane potential and increased tone under conditions in which enteric neurotransmission was blocked. These data suggest that A-type K channels in fundus SMCs are likely active at physiological membrane potentials, and sustained activation of A-type channels contributes to the negative membrane potentials of this tonic smooth muscle. Quantitative analysis of Kv4 expression showed that Kcnd3 was dominantly expressed in fundus SMCs. These data were confirmed by immunohistochemistry which revealed Kv4.3-like immunoreactivity within the tunica muscularis. These observations indicate that Kv4 channels likely form the A-type current in murine fundus SMCs.
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http://dx.doi.org/10.1152/ajpcell.00247.2021DOI Listing
August 2021

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic.

Yeungnam Univ J Med 2021 Aug 23. Epub 2021 Aug 23.

Division of Hematology/Oncology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.

Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic.

Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records.

Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%).

Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician's clinical decision, and patients might not be routinely tested.
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http://dx.doi.org/10.12701/yujm.2021.01144DOI Listing
August 2021

Does hospitalisation impact the successful ageing of community-dwelling older adults?: A propensity score matching analysis using the Korean national survey data.

Int J Older People Nurs 2021 Aug 22:e12413. Epub 2021 Aug 22.

University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA.

Objectives: For community-dwelling older adults with hospitalisation experience, it is necessary to be strategic when promoting successful ageing. This study aimed to investigate whether components of successful ageing (i.e., diseases and complications, functions and engagement with life) differ according to hospitalisation experience in community-dwelling older adults.

Methods: A secondary data analysis with the Korean national survey was performed. Using propensity score matching, 1812 older adults with hospitalisation experience were matched to 1812 older adults without hospitalisation experience. Sampling weight of the survey was considered for all statistical analyses.

Results: The hospitalisation experienced group had more chronic illnesses, malnourishment, impairment in physical function, and depressive symptoms, and less activity in terms of working and social activities. There were no differences in cognitive function or religious activities.

Conclusions: Older adults with hospitalisation experience were less likely to experience successful ageing. To facilitate successful ageing of community-dwelling older adults with hospitalisation experience, nursing interventions for effective transitional care to encourage the use of community resources and participation in social activities are needed.
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http://dx.doi.org/10.1111/opn.12413DOI Listing
August 2021

Placental Macrophages Demonstrate Sex-Specific Response to Intrauterine Inflammation and May Serve as a Marker of Perinatal Neuroinflammation.

J Reprod Immunol 2021 Jul 29;147:103360. Epub 2021 Jul 29.

Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address:

Preterm birth (PTB) is considered to be one of the most frequent causes of neonatal death. Prompt and effective measures to predict adverse fetal outcome following PTB are urgently needed. Placenta macrophages are a critical immune cell population during pregnancy, phenotypically divided into M1 and M2 subsets. An established mouse model of intrauterine inflammation (IUI) was applied. Placenta (labyrinth) and corresponding fetal brain were harvested within 24 hours post injection (hpi). Flow cytometry, Western blot, real-time qPCR, and regular histology were utilized to examine the cytokines, macrophage polarization, and sex-specificity. Placental exposure to LPS led to significantly reduced labyrinth thickness compared to PBS-exposed controls as early as 3 hpi, accompanied by apoptosis and necrosis. Pro-inflammatory M1 markers, Il-1β, and iNOS, and anti-inflammatory M2 marker Il-10 increased significantly in placentas exposed to IUI. Analysis of flow cytometry revealed that fetal macrophages (Hofbauer cell, HBCs) were mostly M1-like and that maternal inter-labyrinth macrophages (MIM) were M2-like in their features in IUI. Male fetuses displayed significantly decreased M2-like features in HBCs at 3 and 6 hpi, while female fetuses showed significant increase in M2-like features in MIM at 3 and 6 hpi. Furthermore, there was a significant correlation between the frequency of HBCs and corresponding microglial marker expression at 3 and 6 hpi. Placental macrophages demonstrated sex-specific features in response to IUI. Specifically, HBCs may be a potential biomarker for fetal brain injury at preterm birth.
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http://dx.doi.org/10.1016/j.jri.2021.103360DOI Listing
July 2021

Deep Learning to Determine the Activity of Pulmonary Tuberculosis on Chest Radiographs.

Radiology 2021 Aug 3:210063. Epub 2021 Aug 3.

From the Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Chongno-gu, Seoul 03080, Korea (S.L., J.M.G., S.H.Y.); Division of Pulmonary and Critical Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (J.J.Y., N.K.); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (Y.J.L.); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (J.K.L.); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, Korea (J.Y.L.); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea (J.S.K.); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (Y.A.K.); Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (D.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (M.J.J.); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea (J.M.G.); and Department of Radiology, UMass Memorial Medical Center, Worcester, Mass (S.H.Y.).

Background Determining the activity of pulmonary tuberculosis on chest radiographs is difficult. Purpose To develop a deep learning model to identify active pulmonary tuberculosis on chest radiographs. Materials and Methods Chest radiographs were retrospectively gathered from a multicenter consecutive cohort with pulmonary tuberculosis who were successfully treated between 2011 and 2017, along with normal radiographs to enrich a negative class. The pretreatment and posttreatment radiographs were labeled as positive and negative classes, respectively. A neural network was trained with those radiographs to calculate the probability of active versus healed tuberculosis. A single-center consecutive cohort (test set 1; 89 patients, 148 radiographs) and data from one multicenter randomized controlled trial (test set 2; 366 patients, 3774 radiographs) were used to test the model. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of the model and of the four expert readers. Results In total, 6654 pre- and posttreatment radiographs from 3327 patients (mean age ± standard deviation, 55 years ± 19; 1884 men) with pulmonary tuberculosis and 3182 normal radiographs from as many patients (mean age, 53 years ± 14; 1629 men) were gathered. For test set 1, the model showed a higher AUC (0.83; 95% CI: 0.73, 0.89) than one pulmonologist (0.69; 95% CI: 0.61, 0.76; < .001) and performed similarly to the other readers (AUC, 0.79-0.80; = .14-.23). For 200 randomly selected radiographs from test set 2, the model had a higher AUC (0.84) than the pulmonologists (0.71 and 0.74; < .001 and .01, respectively) and performed similarly to the radiologists (0.79 and 0.80; = .08 and .06, respectively). The model output increased by 0.30 on average with a higher degree of smear positivity (95% CI: 0.20, 0.39; < .001) and decreased during treatment (baseline, 3 months, and 6 months: 0.85, 0.51, and 0.26, respectively). Conclusion A deep learning model performed similarly to radiologists for accurately determining the activity of pulmonary tuberculosis on chest radiographs; it also was able to follow posttreatment changes. © RSNA, 2021
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http://dx.doi.org/10.1148/radiol.2021210063DOI Listing
August 2021

Plug-in repressor library for precise regulation of metabolic flux in Escherichia coli.

Metab Eng 2021 Sep 30;67:365-372. Epub 2021 Jul 30.

School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk, 37673, South Korea; Department of Chemical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk, 37673, South Korea. Electronic address:

In metabolic engineering, enhanced production of value-added chemicals requires precise flux control between growth-essential competing and production pathways. Although advances in synthetic biology have facilitated the exploitation of a number of genetic elements for precise flux control, their use requires expensive inducers, or more importantly, needs complex and time-consuming processes to design and optimize appropriate regulator components, case-by-case. To overcome this issue, we devised the plug-in repressor libraries for target-specific flux control, in which expression levels of the repressors were diversified using degenerate 5' untranslated region (5' UTR) sequences employing the UTR Library Designer. After we validated a wide expression range of the repressor libraries, they were applied to improve the production of lycopene from glucose and 3-hydroxypropionic acid (3-HP) from acetate in Escherichia coli via precise flux rebalancing to enlarge precursor pools. Consequently, we successfully achieved optimal carbon fluxes around the precursor nodes for efficient production. The most optimized strains were observed to produce 2.59 g/L of 3-HP and 11.66 mg/L of lycopene, which were improved 16.5-fold and 2.82-fold, respectively, compared to those produced by the parental strains. These results indicate that carbon flux rebalancing using the plug-in library is a powerful strategy for efficient production of value-added chemicals in E. coli.
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http://dx.doi.org/10.1016/j.ymben.2021.07.013DOI Listing
September 2021

In-situ cellulose-framework templates mediated monodispersed silver nanoparticles via facile UV-light photocatalytic activity for anti-microbial functionalization.

Carbohydr Polym 2021 Oct 27;269:118255. Epub 2021 May 27.

Department of Bionanotechnology and Bioconvergence Engineering, Graduate School, Jeonbuk National University, Jeonju, Republic of Korea; Division of Mechanical Design Engineering, Jeonbuk National University, Jeonju, Republic of Korea; Eco-Friendly Machine Parts Design Research Center, Jeonbuk National University, Jeonju, Republic of Korea. Electronic address:

Cellulose is well known as a biocompatible material or natural reducing material. In this study, As an eco-friendly and facile method, we prepared monodispersed silver nanoparticles (AgNPs) in cellulose-framework through photocatalytic reaction. and we fabricated electrospun fiber scaffolds with excellent antibacterial properties and biocompatibility. UV-irradiation causes the electrical change of the cellulose-framework, thereby converting Ag ions into Ag particles. We applied a three-electrode system to confirm the phenomenon. Through STEM and EDS, it was found that the synthesized AgNPs were monodisperse in the nanofibers, and antibacterial activity was confirmed using gram-negative and gram-positive bacteria. In addition, it was suggested that the gradual release of simvastatin contained in the nanofibers and excellent mineralization would be easy to apply to bone regeneration. Therefore, the manufactured composite electrospun fiber mat can be used not only in biomedical fields but also in various applications that need to prevent the accumulation of microorganisms.
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http://dx.doi.org/10.1016/j.carbpol.2021.118255DOI Listing
October 2021

Daytime Glycemic Variability and Frailty in Older Patients with Diabetes: a Pilot Study Using Continuous Glucose Monitoring.

J Korean Med Sci 2021 Jul 12;36(27):e190. Epub 2021 Jul 12.

Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

We investigated the relationship between glucose variability and frailty. Forty-eight type 2 diabetic patients aged ≥ 65 years were enrolled. The FRAIL scale was used for frailty assessment, and participants were classified into 'healthy & pre-frail' (n = 24) and 'frail' (n = 24) groups. A continuous glucose monitoring (CGM) system was used for a mean of 6.9 days and standardized CGM metrics were analyzed: mean glucose, glucose management indicator (GMI), coefficient of variation, and time in range, time above range (TAR), and time below range. The demographics did not differ between groups. However, among the CGM metrics, mean glucose, GMI, and TAR in the postprandial periods were higher in the frail group (all < 0.05). After multivariate adjustments, the post-lunch TAR (OR = 1.12, = 0.019) affected the prevalence of frailty. Higher glucose variability with marked daytime postprandial hyperglycemia is significantly associated with frailty in older patients with diabetes.
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http://dx.doi.org/10.3346/jkms.2021.36.e190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8275461PMC
July 2021

Effects of education, income, and occupation on prevalence and symptoms of knee osteoarthritis.

Sci Rep 2021 Jul 7;11(1):13983. Epub 2021 Jul 7.

Division of Rheumatology, Department of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

To examine the effect of socioeconomic status (SES) as measured by three components of education level, income level, and occupation on prevalence and symptom severity of knee osteoarthritis (OA) and to determine which of these factors has the strongest association. We conducted a cross-sectional study using data from the Fifth Korean National Health and Nutrition Examination Survey that were collected between 2010 and 2012. Male and female participants 50 years or older were included. Analyses to examine the associations of the three SES components with prevalence and symptom severity of knee OA were performed. A total 9,071 participants was included in the study. As expected, lower education, lower income level, and non-managerial or no job were associated with higher prevalence of knee OA and knee symptoms. Among the three SES components, lower education was most strongly associated with knee pain and radiographic knee OA after adjusting for the other two. Lower education level is the component of SES that most strongly relates to higher prevalence of knee OA and knee symptoms. Improving societal education level might decrease the socioeconomic burden of knee OA.
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http://dx.doi.org/10.1038/s41598-021-93394-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263710PMC
July 2021

Neuroprotective Effects of Flower Extract against Oxidative Stress-Induced Apoptosis in Neuronal Cells and Mice.

Antioxidants (Basel) 2021 Jun 12;10(6). Epub 2021 Jun 12.

Department of Herbal Crop Research, National Institute of Horticultural & Herbal Science, Eumsung 27709, Korea.

L. is a perennial plant of the family Asteraceae, and its flower is known to contain flavonoids with various bioactivities. We evaluated the effect of L. flower (CLF) extracts on HO-induced oxidative stress (OS) in neuronal cells and mouse neurons. The flowering part of CL was used as CLF1 (70% ethanol extract) and CLF2 (water extract), and 10 types of phenolic compounds were quantified using high-performance liquid chromatography. To evaluate the neuroprotective effects of CLF, the antioxidant activities of the extracts were measured, and the expression levels of antioxidant enzymes and proteins related to OS-induced apoptosis in neuronal cells and mouse neurons treated with the extracts were investigated. In the in vitro study, CLF ameliorated HO-induced oxidative stress and induced the expression of antioxidant enzymes in PC12 cells. Furthermore, CLF1 enhanced the expression of the Bcl-xL protein but reduced the expression of Bax and the cleavage of caspase-3. In the same manner, CLF1 showed neuroprotective effects against OS in vivo. Pretreatment with CLF1 (200 mg/kg) increased the Bcl-2 protein and decreased Bax compared with the 1-methyl-4-phenylpyridinium ion (MPP+)-treated C57BL/6 mice model group. Our results suggest that the protective effects of CLF1 on MPP+-induced apoptosis may be due to its anti-apoptotic activity, through regulating the expression of the Bcl-2 family. CLF1 exerts neuroprotective effects against OS-induced apoptosis in PC12 cells in a Parkinson's disease model mouse. This effect may be attributable to the upregulation of Bcl-2 protein expression, downregulation of Bax expression, and inhibition of caspase-3 activation. These data indicate that CLF may provide therapeutic value for the treatment of progressive neurodegenerative diseases.
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http://dx.doi.org/10.3390/antiox10060951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231104PMC
June 2021

Ubiquitin-Conjugating Enzymes in Cancer.

Cells 2021 Jun 4;10(6). Epub 2021 Jun 4.

Department of Biomedical Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

The ubiquitin-mediated degradation system is responsible for controlling various tumor-promoting processes, including DNA repair, cell cycle arrest, cell proliferation, apoptosis, angiogenesis, migration and invasion, metastasis, and drug resistance. The conjugation of ubiquitin to a target protein is mediated sequentially by the E1 (activating)‒E2 (conjugating)‒E3 (ligating) enzyme cascade. Thus, E2 enzymes act as the central players in the ubiquitination system, modulating various pathophysiological processes in the tumor microenvironment. In this review, we summarize the types and functions of E2s in various types of cancer and discuss the possibility of E2s as targets of anticancer therapeutic strategies.
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http://dx.doi.org/10.3390/cells10061383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227520PMC
June 2021

Mealtime caregiving approaches and behavioral symptoms in persons living with dementia: a longitudinal, observational study.

BMC Nurs 2021 Jun 21;20(1):104. Epub 2021 Jun 21.

Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs (VA) Medical Center, Duke University School of Nursing, Durham, NC, USA.

Background: Behavioral symptoms during mealtime can prohibit persons living with dementia from obtaining sufficient nutrition. However, little research has examined the relationship between behavioral symptoms and caregiving approaches. This study examines this relationship and further explores which specific caregiver behaviors were related to behavioral symptoms among persons living with dementia.

Methods: A secondary data analysis was performed using 86 mealtime videos from a longitudinal, observational study. The videos were repeatedly taken at months 0, 3, and 6 with 30 persons living with dementia in one of four long-term care facilities. Video coding was performed using coding schemes modified from the Cohen-Mansfield Agitation Inventory for behavioral symptoms and the Person-/Task-Centered Behavior Inventory for caregiving approaches. Coding schemes for behavioral symptoms consisted of four categories: total duration, aggressive behavior, physically nonaggressive behavior, and verbally agitated behavior. Caregiving approaches consisted of ten-verbal/seven-nonverbal person-centered behavior codes, four-verbal/four-nonverbal task-centered behavior codes, and no-verbal/no-nonverbal interaction codes. A mixed-effect model was conducted using variables such as demographics, medical information, cognitive status, depression, function, and caregiving approaches as fixed effects, participant as a random effect, and four categories of behavioral symptoms as dependent variables.

Results: The total duration of the Cohen-Mansfield Agitation Inventory was associated with no verbal response (β = 9.09) and task-centered verbal behavior (β = 8.43), specifically verbal controlling (β = 7.87). Physically nonaggressive behavior was associated with no verbal response (β = 9.36). Verbally agitated behavior was associated with task-centered nonverbal behavior (β = 51.29), and specifically inappropriate touch (β = 59.05).

Conclusions: Mealtime is indispensable to dementia care for ensuring adequate nutrition and promoting personhood. Our findings revealed caregivers' task-centered behaviors and no interaction were related to behavioral symptoms of persons living with dementia. When caregivers encounter behavioral symptoms during mealtime, it is recommended to avoid no response and task-centered behaviors, especially verbal controlling and inappropriate touch, and to promote person-centered behaviors.
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http://dx.doi.org/10.1186/s12912-021-00621-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215775PMC
June 2021

Ultrahigh-field cardiovascular magnetic resonance T1 and T2 mapping for the assessment of anthracycline-induced cardiotoxicity in rat models: validation against histopathologic changes.

J Cardiovasc Magn Reson 2021 06 17;23(1):76. Epub 2021 Jun 17.

Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Severance Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Background: Chemotherapy-induced cardiotoxicity is a well-recognized adverse effect of chemotherapy. Quantitative T1-mapping cardiovascular magnetic resonance (CMR) is useful for detecting subclinical myocardial changes in anthracycline-induced cardiotoxicity. The aim of the present study was to histopathologically validate the T1 and T2 mapping parameters for the evaluation of diffuse myocardial changes in rat models of cardiotoxicity.

Methods: Rat models of cardiotoxicity were generated by injecting rats with doxorubicin (1 mg/kg, twice a week). CMR was performed with a 9.4 T ultrahigh-field scanner using cine, pre-T1, post-T1 and T2 mapping sequences to evaluate the left ventricular ejection fraction (LVEF), native T1, T2, and extracellular volume fraction (ECV). Histopathological examinations were performed and the association of histopathological changes with CMR parameters was assessed.

Results: Five control rats and 36 doxorubicin-treated rats were included and classified into treatment periods. In the doxorubicin-treated rats, the LVEF significantly decreased after 12 weeks of treatment (control vs. 12-week treated: 73 ± 4% vs. 59 ± 9%, P = 0.01).  Increased native T1 and ECV were observed after 6 weeks of treatment (control vs. 6-week treated: 1148 ± 58 ms, 14.3 ± 1% vs. 1320 ± 56 ms, 20.3 ± 3%; P = 0.005, < 0.05, respectively). T2 values also increased by six weeks of treatment (control vs. 6-week treated: 16.3 ± 2 ms vs. 10.3 ± 1 ms, P < 0.05). The main histopathological features were myocardial injury, interstitial fibrosis, inflammation, and edema. The mean vacuolar change (%), fibrosis (%), and inflammation score were significantly higher in 6-week treated rats than in the controls (P = 0.03, 0.03, 0.02, respectively). In the univariable analysis, vacuolar change showed the highest correlation with native T1 value (R = 0.60, P < 0.001), and fibrosis showed the highest correlation with ECV value (R = 0.78, P < 0.001). In the multiple linear regression analysis model, vacuolar change was a significant factor for change in native T1 (P = 0.01), and vacuolar change and fibrosis were significant factors for change in ECV (P = 0.006, P < 0.001, respectively) by adding other histopathological parameters (i.e., inflammation and edema scores) CONCLUSIONS: Quantitative T1 and T2 mapping CMR is a useful non-invasive tool reflecting subclinical histopathological changes in anthracycline-induced cardiotoxicity.
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http://dx.doi.org/10.1186/s12968-021-00767-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210390PMC
June 2021

The Experiences of Health Care Workers during the COVID-19 Pandemic in Korea: a Qualitative Study.

J Korean Med Sci 2021 Jun 14;36(23):e170. Epub 2021 Jun 14.

Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have faced multiple physical and psychological challenges while carrying out their duties. In this study, we examined the experiences of specific groups of HCWs during the pandemic.

Methods: From 18 November to 30 December 2020, we conducted a qualitative study using semi-structured, face-to-face interviews with four groups of 14 HCWs in three cities (Seoul, Daegu, and Gwangju) in South Korea. The HCWs who participated in the focus groups included physicians, nurses, medical practitioners, and cleaning staff who directly or indirectly cared for patients during the COVID-19 epidemic. Interviews were transcribed verbatim and analyzed using the consensual qualitative research approach.

Results: Our qualitative data analysis revealed four main domains: work-related struggles, personal life-related struggles, psychological stress, and health-related struggles. Health care providers were challenged by working in critical situations and were overwhelmed by heavy workloads, fear of infection, lifestyle changes, and psychological and physical struggles.

Conclusion: Our findings could serve as a foundation for establishing health care systems and policies that help HCWs cope with occupational stress, thus increasing their ability to adapt to the ongoing COVID-19 pandemic.
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http://dx.doi.org/10.3346/jkms.2021.36.e170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203853PMC
June 2021

Modeling Clinical Responses to Targeted Therapies by Patient-Derived Organoids of Advanced Lung Adenocarcinoma.

Clin Cancer Res 2021 Aug 3;27(15):4397-4409. Epub 2021 Jun 3.

Division of Medical Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Korea.

Purpose: Patient-derived organoids (PDO) of lung cancer has been recently introduced, reflecting the genomic landscape of lung cancer. However, clinical relevance of advanced lung adenocarcinoma organoids remains unknown. Here, we examined the ability of PDOs to predict clinical responses to targeted therapies in individual patients and to identify effective anticancer therapies for novel molecular targets.

Experimental Design: Eighty-four organoids were established from patients with advanced lung adenocarcinoma. Formalin-fixed, paraffin-embedded tumor specimens from corresponding patients were analyzed by whole-exome sequencing ( = 12). Organoids were analyzed by whole-exome sequencing ( = 61) and RNA sequencing ( = 55). Responses to mono or combination targeted therapies were examined in organoids and organoid-derived xenografts.

Results: PDOs largely retained somatic alterations including driver mutations of matching patient tumors. PDOs were able to recapitulate progression-free survival and objective responses of patients with non-small cell lung cancer receiving clinically approved tyrosine kinase inhibitors. PDOs recapitulated activity of therapeutic strategies under clinical investigation. YUO-071 harboring an exon 19 deletion and a G464A mutation and the matching patient responded to dabrafenib/trametinib combination therapy. YUO-004 and YUO-050 harboring an L747P mutation was sensitive to afatinib, consistent with the response in the matching patient of YUO-050. Furthermore, we utilized organoids to identify effective therapies for novel molecular targets by demonstrating the efficacy of poziotinib against exon 20 insertions and pralsetinib against fusions.

Conclusions: We demonstrated translational relevance of PDOs in advanced lung adenocarcinoma. PDOs are an important diagnostic tool, which can assist clinical decision making and accelerate development of therapeutic strategies.
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http://dx.doi.org/10.1158/1078-0432.CCR-20-5026DOI Listing
August 2021

Effects of Graphene Oxide on Germination and Early Growth of Plants.

J Nanosci Nanotechnol 2021 10;21(10):5282-5288

Department of Environmental Engineering, Konkuk University, Seoul 05029, Republic of Korea.

Owing to its excellent material properties such as large surface area and superb mechanical and thermal characteristics, graphene oxide (GO) is likely to be applied in a variety of environmental fields. These applications may lead to the entrance of GO in terrestrial ecosystems, but there is little research regarding the impact of GO on plants upon such entrances. To analyze the effects of GO on the germination and growth of various plants, the changes in lettuce, radish, perennial ryegrass, alfalfa, and cucumber seeds under GO treatment was studied. Germination rate and growth were analyzed after the seeds were exposed to GO at 0, 0.2, 0.4, 0.8, and 1.6 mg ml. For lettuce, the germination rate decreased with GO concentration. However, no significant effects were observed on the germination rate of other plants. On the other hand, the growth of lettuce, alfalfa, and radish decreased under GO treatment. For example, at 1.6 mg ml of GO, the length of shoot and root of lettuce was shortened by 87% and 86%, respectively. Such results indicate that the germination and early growth of plants can be negatively affected in a species-specific manner under high concentrations of GO. Hence, we anticipate that our results may assist in supplementing the legal regulations for the proper disposal of nanomaterials.
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http://dx.doi.org/10.1166/jnn.2021.19361DOI Listing
October 2021

Identifying the Risk Factors Associated with Nursing Home Residents' Pressure Ulcers Using Machine Learning Methods.

Int J Environ Res Public Health 2021 03 13;18(6). Epub 2021 Mar 13.

School of Nursing, University of Texas at Austin, Austin, TX 78712, USA.

Background: Machine learning (ML) can keep improving predictions and generating automated knowledge via data-driven predictors or decisions.

Objective: The purpose of this study was to compare different ML methods including random forest, logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, and sigmoid SVM in terms of their accuracy, sensitivity, specificity, negative predictor values, and positive predictive values by validating real datasets to predict factors for pressure ulcers (PUs).

Methods: We applied representative ML algorithms (random forest, logistic regression, linear SVM, polynomial SVM, radial SVM, and sigmoid SVM) to develop a prediction model (N = 60).

Results: The random forest model showed the greatest accuracy (0.814), followed by logistic regression (0.782), polynomial SVM (0.779), radial SVM (0.770), linear SVM (0.767), and sigmoid SVM (0.674).

Conclusions: The random forest model showed the greatest accuracy for predicting PUs in nursing homes (NHs). Diverse factors that predict PUs in NHs including NH characteristics and residents' characteristics were identified according to diverse ML methods. These factors should be considered to decrease PUs in NH residents.
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http://dx.doi.org/10.3390/ijerph18062954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001016PMC
March 2021

Low-voltage-activated inward current in murine antral smooth muscle cells is an artifact.

Am J Physiol Cell Physiol 2021 06 31;320(6):C966-C973. Epub 2021 Mar 31.

Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, Nevada.

Two types of voltage-dependent inward currents were evoked by depolarization in murine antral smooth muscle cells (SMCs) bathed in Ca-containing physiological solution: high-voltage-activated (HVA) and low-voltage-activated (LVA) inward currents. We examined whether the LVA current was due to: ) T-type Ca channels, ) Ca-activated Clchannels, ) nonselective cation channels (NSCC), or ) voltage-dependent K channels. Replacement of external Ca (2 mM) with equimolar Ba increased the amplitude of the HVA current but blocked the LVA current. Nicardipine blocked the HVA current, and in the presence of nicardipine, T-type Ca blockers failed to block LVA current. A Cl channel antagonist had little effect on LVA current. Cation-free external solution completely abolished both HVA and LVA currents. Addition of Ca to the solution restored only HVA currents. Addition of K (5 mM) to otherwise cation-free solution induced LVA current that reversed at -20 mV. These data suggest that LVA current is not due to T-type Ca channels, Ca-activated Cl channels, or NSCC. A-type K (K) currents and delayed rectifying K (K) currents can be resolved in antral SMCs dialyzed with a solution containing 140 mM K. When cells were exposed to high K external solution and dialyzed with Cs-rich solution in the presence of nicardipine, LVA current was evoked and reversed at positive potentials. LVA currents were blocked by K channel blockers, 4-aminopyridine, and tetraethylammonium. In conclusion, LVA inward currents can be generated by K influx via K channels in murine antral SMCs when cells were dialyzed with Cs-rich solution.
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http://dx.doi.org/10.1152/ajpcell.00031.2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285640PMC
June 2021

Korean Christian Young Adults' Religiosity Affects Post-traumatic Growth: The Mediation Effects of Forgiveness and Gratitude.

J Relig Health 2021 Mar 7. Epub 2021 Mar 7.

Hankuk University of Foreign Studies, 107 Imunro, Dongdaemun-gu, Seoul, 130-791, South Korea.

This study examines the mediation effects of forgiveness and gratitude in the association between Korean Christian young adults' religiosity and post-traumatic growth. The participants are 296 Christian young adults in Korea. We hypothesize that the association between young Christian young adults' religiosity and post-traumatic growth is mediated by forgiveness and gratitude. The hypothesized model is tested by structural equation modeling. Results confirm that the religiosity of Christian young adults affects post-traumatic growth through forgiveness and gratitude. Adding a direct path from religiosity to post-traumatic growth significantly improved the model fit, which suggests partial mediation of forgiveness and gratitude in the association between religiosity and post-traumatic growth.
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http://dx.doi.org/10.1007/s10943-021-01213-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937049PMC
March 2021

Ipragliflozin, an SGLT2 Inhibitor, Ameliorates High-Fat Diet-Induced Metabolic Changes by Upregulating Energy Expenditure through Activation of the AMPK/SIRT1 Pathway.

Diabetes Metab J 2021 Feb 22. Epub 2021 Feb 22.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Background: Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of antidiabetic drugs that exhibit multiple extraglycemic effects. However, there are conflicting results regarding the effects of SGLT2 inhibition on energy expenditure and thermogenesis. Therefore, we investigated the effect of ipragliflozin (a selective SGLT2 inhibitor) on energy metabolism.

Methods: Six-week-old male 129S6/Sv mice with a high propensity for adipose tissue browning were randomly assigned to three groups: normal chow control, 60% high-fat diet (HFD)-fed control, and 60% HFD-fed ipragliflozin-treated groups. The administration of diet and medication was continued for 16 weeks.

Results: The HFD-fed mice became obese and developed hepatic steatosis and adipose tissue hypertrophy, but their random glucose levels were within the normal ranges; these features are similar to the metabolic features of a prediabetic condition. Ipragliflozin treatment markedly attenuated HFD-induced hepatic steatosis and reduced the size of hypertrophied adipocytes to that of smaller adipocytes. In the ipragliflozin treatment group, uncoupling protein 1 (Ucp1) and other thermogenesis-related genes were significantly upregulated in the visceral and subcutaneous adipose tissue, and fatty acid oxidation was increased in the brown adipose tissue. These effects were associated with a significant reduction in the insulin-to-glucagon ratio and the activation of the AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1) pathway in the liver and adipose tissue.

Conclusion: SGLT2 inhibition by ipragliflozin showed beneficial metabolic effects in 129S6/Sv mice with HFD-induced obesity that mimics prediabetic conditions. Our data suggest that SGLT2 inhibitors, through their upregulation of energy expenditure, may have therapeutic potential in prediabetic obesity.
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http://dx.doi.org/10.4093/dmj.2020.0187DOI Listing
February 2021

The Role of TRP Channels and PMCA in Brain Disorders: Intracellular Calcium and pH Homeostasis.

Front Cell Dev Biol 2021 28;9:584388. Epub 2021 Jan 28.

Gachon Pain Center, Department of Physiology, Gachon University College of Medicine, Incheon, South Korea.

Brain disorders include neurodegenerative diseases (NDs) with different conditions that primarily affect the neurons and glia in the brain. However, the risk factors and pathophysiological mechanisms of NDs have not been fully elucidated. Homeostasis of intracellular Ca concentration and intracellular pH (pH) is crucial for cell function. The regulatory processes of these ionic mechanisms may be absent or excessive in pathological conditions, leading to a loss of cell death in distinct regions of ND patients. Herein, we review the potential involvement of transient receptor potential (TRP) channels in NDs, where disrupted Ca homeostasis leads to cell death. The capability of TRP channels to restore or excite the cell through Ca regulation depending on the level of plasma membrane Ca ATPase (PMCA) activity is discussed in detail. As PMCA simultaneously affects intracellular Ca regulation as well as pH, TRP channels and PMCA thus play vital roles in modulating ionic homeostasis in various cell types or specific regions of the brain where the TRP channels and PMCA are expressed. For this reason, the dysfunction of TRP channels and/or PMCA under pathological conditions disrupts neuronal homeostasis due to abnormal Ca and pH levels in the brain, resulting in various NDs. This review addresses the function of TRP channels and PMCA in controlling intracellular Ca and pH, which may provide novel targets for treating NDs.
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http://dx.doi.org/10.3389/fcell.2021.584388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876282PMC
January 2021

Melatonin for the prevention of fetal injury associated with intrauterine inflammation.

Am J Reprod Immunol 2021 07 25;86(1):e13402. Epub 2021 Feb 25.

Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Intrauterine inflammation is shown to be associated with preterm birth, fetal inflammatory response syndrome, and other pregnancy-related comorbidities such as central nervous system diseases including cerebral palsy and periventricular leukomalacia, pulmonary diseases such as bronchopulmonary dysplasia and respiratory distress syndrome, and necrotizing enterocolitis, to name a few. Many animal studies on intrauterine inflammation demonstrate that ascending infection of reproductive organs or the production of proinflammatory cytokines by some stimuli in utero results in such manifestations. Melatonin, known for its primary function in maintaining circadian rhythm, is now recognized as one of the most potent antioxidant and anti-inflammatory drugs. In some studies, melatonin injection in pregnant animals with intrauterine inflammation significantly reduced the number of preterm births, the severity of structural disintegration of the fetal lungs observed in bronchopulmonary dysplasia, and perinatal brain injuries with improvement in neuromotor function. These implicated benefits of melatonin in pregnant women with intrauterine inflammation seem promising in many research studies, strongly supporting the hypothesis that melatonin has antioxidative and anti-inflammatory properties that can potentially be taken by pregnant women who are at risk of having intrauterine inflammation. In this review, the potential of melatonin for improving outcomes of the pregnancies with intrauterine inflammation will be discussed.
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http://dx.doi.org/10.1111/aji.13402DOI Listing
July 2021

Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (1) Prenatal Aneuploidy Screening.

J Korean Med Sci 2021 Jan 25;36(4):e27. Epub 2021 Jan 25.

Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

In 2019, the Korean Society of Maternal-Fetal Medicine developed the first Korean clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing. These guidelines were developed by adapting established clinical practice guidelines in other countries that were searched systematically, and the guidelines aim to assist in decision making of healthcare providers providing prenatal care and to be used as a source for education and communication with pregnant women in Korea. This article delineates clinical practice guidelines specifically for maternal serum screening for fetal aneuploidy and cell-free DNA (cfDNA) screening. A total of 19 key questions (12 for maternal serum and 7 for cfDNA screening) were defined. The main recommendations are: 1) Pregnant women should be informed of common fetal aneuploidy that can be detected, risks for chromosomal abnormality according to the maternal age, detection rate and false positive rate for common fetal aneuploidy with each screening test, limitations, as well as the benefits and risks of invasive diagnostic testing, 2) It is ideal to give counseling about prenatal aneuploidy screening and diagnostic testing at the first prenatal visit, and counseling is recommended to be given early in pregnancy, 3) All pregnant women should be informed about maternal serum screening regardless of their age, 4) cfDNA screening can be used for the screening of trisomy 21, 18, 13 and sex-chromosome aneuploidy. It is not recommended for the screening of microdeletion, 5) The optimal timing of cfDNA screening is 10 weeks of gestation and beyond, and 6) cfDNA screening is not recommended for women with multiple gestations. The guideline was reviewed and approved by the Korean Academy of Medical Sciences.
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http://dx.doi.org/10.3346/jkms.2021.36.e27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834900PMC
January 2021

Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (2) Invasive Diagnostic Testing for Fetal Chromosomal Abnormalities.

J Korean Med Sci 2021 Jan 25;36(4):e26. Epub 2021 Jan 25.

Mirae & Heemang Obstetrics and Gynecology Clinic, Seoul, Korea.

The Korean Society of Maternal Fetal Medicine proposed the first Korean guideline on prenatal aneuploidy screening and diagnostic testing, in April 2019. The clinical practice guideline (CPG) was developed for Korean women using an adaptation process based on good-quality practice guidelines, previously developed in other countries, on prenatal screening and invasive diagnostic testing for fetal chromosome abnormalities. We reviewed current guidelines and developed a Korean CPG on invasive diagnostic testing for fetal chromosome abnormalities according to the adaptation process. Recommendations for selected 11 key questions are: 1) Considering the increased risk of fetal loss in invasive prenatal diagnostic testing for fetal genetic disorders, it is not recommended for all pregnant women aged over 35 years. 2) Because early amniocentesis performed before 14 weeks of pregnancy increases the risk of fetal loss and malformation, chorionic villus sampling (CVS) is recommended for pregnant women who will undergo invasive prenatal diagnostic testing for fetal genetic disorders in the first trimester of pregnancy. However, CVS before 9 weeks of pregnancy also increases the risk of fetal loss and deformity. Thus, CVS is recommended after 9 weeks of pregnancy. 3) Amniocentesis is recommended to distinguish true fetal mosaicism from confined placental mosaicism. 4) Anti-immunoglobulin should be administered within 72 hours after the invasive diagnostic testing. 5) Since there is a high risk of vertical transmission, an invasive prenatal diagnostic testing is recommended according to the clinician's discretion with consideration of the condition of the pregnant woman. 6) The use of antibiotics is not recommended before or after an invasive diagnostic testing. 7) The chromosomal microarray test as an alternative to the conventional cytogenetic test is not recommended for all pregnant women who will undergo an invasive diagnostic testing. 8) Amniocentesis before 14 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 9) CVS before 9 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 10) Although the risk of fetal loss associated with invasive prenatal diagnostic testing (amniocentesis and CVS) may vary based on the proficiency of the operator, the risk of fetal loss due to invasive prenatal diagnostic testing is higher in twin pregnancies than in singleton pregnancies. 11) When a monochorionic twin is identified in early pregnancy and the growth and structure of both fetuses are consistent, an invasive prenatal diagnostic testing can be performed on one fetus alone. However, an invasive prenatal diagnostic testing is recommended for each fetus in cases of pregnancy conceived via in vitro fertilization, or in cases in which the growth of both fetuses differs, or in those in which at least one fetus has a structural abnormality. The guidelines were established and approved by the Korean Academy of Medical Sciences. This guideline is revised and presented every 5 years.
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http://dx.doi.org/10.3346/jkms.2021.36.e26DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834898PMC
January 2021

Depletion of CTCF disrupts PSG gene expression in the human trophoblast cell line Swan 71.

FEBS Open Bio 2021 03 2;11(3):804-812. Epub 2021 Mar 2.

Department of Anatomy, Embryology Laboratory, Yonsei University College of Medicine, Seoul, Korea.

Pregnancy-specific glycoproteins (PSGs) are fetal proteins secreted by the placenta during pregnancy. The PSG level in maternal serum is an indicator of risk for pregnancy complications. However, little is known about the molecular mechanisms underlying PSG gene expression. Recently, the importance of epigenetic regulation of placental genes has been emphasized in the study of developmental defects and placental disease. In this study, the role of the CCCTC-binding factor (CTCF) in regulation of PSG expression was investigated to better understand the epigenetic regulatory mechanisms of the PSG genes. Inhibition of CTCF expression disturbed transcription of several PSG genes: PSG1, PSG2, PSG4, PSG5, PSG8, and PSG9 were upregulated and PSG6 and PSG11 were downregulated. These transcriptional changes were correlated with decreased CTCF binding and changes in histone modification at the PSG promoters. Our data demonstrate that CTCF is a potential mediator in the regulation of PSG gene expression.
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http://dx.doi.org/10.1002/2211-5463.13087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931220PMC
March 2021

Increasing Registered Nurse Hours Per Resident Day for Improved Nursing Home Residents' Outcomes Using a Longitudinal Study.

Int J Environ Res Public Health 2021 01 6;18(2). Epub 2021 Jan 6.

Department of Psychology, Arizona State University, Tempe, AZ 85281, USA.

The purpose of this study was to estimate how much resident outcomes can improve with an increase in hours per resident day (HPRD) of registered nurses (RNs) staffing. Nursing home (NH) staff in Korea have serious problems with inappropriate nurse staffing standards and poor working conditions, which lead to poor quality of care for NH residents. This study used a longitudinal survey design. A quota sampling was used with a total of several repeated survey measurement from 2017 to 2020 ( = 74). The independent variable was the amount of nurse staffing HPRD and the outcome variable was the compiled outcome of 15 quality-of-care indicators. Data were directly collected from all participating NHs. A longitudinal, multilevel model was used for analysis. An increase of one unit of RN HPRD (60 min) corresponded to a decrease of about 10.5% of residents with deteriorated quality of care outcomes. This study emphasized that increasing RN HPRD decreased residents' deteriorated outcomes in NHs. This suggests that professional RNs must be secured to an appropriate level to improve the quality of care for NH residents.
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http://dx.doi.org/10.3390/ijerph18020402DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825529PMC
January 2021

A Randomized Comparison Between Two Injections from Two Planes versus Two Injections with a Uniplanar Approach for Ultrasound-Guided Supraclavicular Block.

Pain Physician 2021 01;24(1):E15-E21

Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, Incheon, South Korea.

Background: The brachial plexus courses along the lateral to posterior aspect of the subclavian artery located within the supraclavicular region as a trunk or division. Therefore we hypothesized that 2 injections, one along the lateral and one along the posterior aspect of the brachial plexus, could be performed by changing the angle of the ultrasound probe, thereby achieving a 3-dimensional (3-D) even distribution of local anesthetics. Previously, we confirmed the efficacy of this type of approach with that of a single cluster approach. These findings represent a subsequent study.

Objectives: This study was conducted to confirm the superiority of block quality achieved by 2 injections from 2 planes (control group; group C) over 2 injections in one plane (experimental group; group E).

Study Design: A randomized, controlled trial.

Setting: Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center.

Methods: In group C (n = 35), the brachial plexus sheath was penetrated in 2 planes by anteriorly altering the angle of the ultrasound probe without changing its position. In group E (n = 35), the upper and lower portions of the brachial plexus sheath were penetrated in one plane. A total of 15 mL of lidocaine 1.5% containing epinephrine (1:200,000) was injected at each point in both groups. The ultrasound-guided supraclavicular brachial plexus block was evaluated every 5 minutes for 30 minutes. The main outcome variables were rates of blockage of all 4 nerves and ulnar nerve sparing.

Results: The rate of blockage of all 4 nerves (median, ulnar, radial, and musculocutaneous nerves) was not significantly different between the 2 groups (94% in group C vs. 86% in group E, respectively; P = 0.232). The number of spared ulnar nerves was similar (1 vs. 5, respectively; P = 0.088). Group procedure times, onset times, and Visual Analog Scale scores for the blocks were similar.

Limitations: For the 2 plane, 2 injection approach, only 2-D imaging was performed rather than 3-D imaging.

Conclusions: Two injections performed in one plane offered similar benefits to 2 injections performed in 2 planes. The 2 techniques provided comparable block qualities and could be viewed as equally effective alternatives.
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January 2021

Correction to: Using the Theory of Planned Behavior to Predict Korean College Students' Help-Seeking Intention.

J Behav Health Serv Res 2020 Dec 16. Epub 2020 Dec 16.

Department of Education, Seoul National University, Seoul, 08826, Republic of Korea.

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http://dx.doi.org/10.1007/s11414-020-09744-yDOI Listing
December 2020

Serologic Evaluation of Healthcare Workers Caring for COVID-19 Patients in the Republic of Korea.

Front Microbiol 2020 20;11:587613. Epub 2020 Nov 20.

Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

The safety of healthcare workers (HCWs) against severe acute respiratory syndrome virus 2 (SARS-CoV-2) transmission is an important aspect of managing the coronavirus disease 2019 (COVID-19) pandemic. In the South Korea, highly stringent infection prevention and control (IPC) guidelines are implemented, and reports of healthcare-associated SARS-CoV-2 transmission among HCWs are limited. However, subclinical infections may have been missed by the current symptom-based screening strategy. To evaluate the risk of undetected SARS-CoV-2 transmissions from COVID-19 patients to HCWs, we conducted a multicenter seroprevalence study after the first surge of the COVID-19 outbreak. A total of 432 HCWs were evaluated, comprising 309 HCWs designated to laboratory-confirmed COVID-19 patient care and 123 non-designated HCWs. Designated HCWs wore personal protective equipment including an N95 respirator, eye protection, hooded overalls, shoe covers, and inner and outer gloves. Use of a powered air-purifying respirator was recommended for aerosol-generating procedures or long-duration care activities. A high-sensitivity (99.1%) fluorescence immunoassay immunoglobulin G (IgG) kit was used as the initial screening test, and two enzyme-linked immunosorbent assay kits for total and IgG antibodies were used to confirm the test results. A microneutralization test was additionally performed to evaluate the neutralizing activity of positive specimens. Among the evaluated HCWs, none of the non-designated HCWs had a positive result, while one of the HCWs designated for COVID-19 patient care (1/309, 0.3%) was seropositive for SARS-CoV-2 with confirmed neutralizing activity (1:40). This finding suggests that subclinical seroconversion may occur among HCWs caring for COVID-19 patients, although the risk is low under strict IPC guidance.
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http://dx.doi.org/10.3389/fmicb.2020.587613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714715PMC
November 2020

Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis.

Gerontologist 2020 Dec 16. Epub 2020 Dec 16.

Yonsei University College of Nursing, Seoul, South Korea.

Background And Objectives: The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness.

Research Design And Methods: A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement.

Results: In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function.

Discussion And Implications: Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.
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http://dx.doi.org/10.1093/geront/gnaa207DOI Listing
December 2020
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