Can pleural adenosine deaminase (ADA) levels in pleural tuberculosis predict the presence of pulmonary tuberculosis? A CT analysis.

AIM: To assess the relationship between imaging features of pulmonary tuberculosis at computed tomography (CT) and adenosine deaminase (ADA) values via pleural fluid analysis in patients with pleural tuberculosis. MATERIALS AND METHODS: This retrospective study enrolled 60 patients who underwent fluid analysis for ADA and chest CT and were diagnosed with tuberculosis by culture or polymerase chain reaction of pleural fluid and sputum. The presence of centrilobular nodules, consolidation, cavitation, and mediastinal lymphadenopathy at CT were evaluated. The relationship between ADA values and the pattern of pulmonary involvement of tuberculosis was analysed. RESULTS: Pulmonary involvement was seen in 42 of the 60 patients. A centrilobular nodular pattern was seen in 37 and consolidation in 22. In 17 patients, both findings were identified. A centrilobular nodular pattern was more common than consolidation or cavitary lesions. When ADA values were high, pulmonary involvement was more frequent (p=0.002). Comparing low and high ADA groups using an obtained cut-off value of 80 IU/l, the high group had more frequent pulmonary involvement (p<0.001). CONCLUSION: Patients with tuberculous pleurisy who had high ADA values had a higher probability of manifesting pulmonary tuberculosis. High ADA values may help predict contagious pleuroparenchymal tuberculosis. The most common pulmonary involvement of tuberculous pleurisy showed a centrilobular nodular pattern.

Estimation of Thermal Sensation Based on Wrist Skin Temperatures.

Thermal comfort is an essential environmental factor related to quality of life and work effectiveness. We assessed the feasibility of wrist skin temperature monitoring for estimating subjective thermal sensation. We invented a wrist band that simultaneously monitors skin temperatures from the wrist (i.e., the radial artery and ulnar artery regions, and upper wrist) and the fingertip. Skin temperatures from eight healthy subjects were acquired while thermal sensation varied. To develop a thermal sensation estimation model, the mean skin temperature, temperature gradient, time differential of the temperatures, and average power of frequency band were calculated. A thermal sensation estimation model using temperatures of the fingertip and wrist showed the highest accuracy (mean root mean square error [RMSE]: 1.26 ± 0.31). An estimation model based on the three wrist skin temperatures showed a slightly better result to the model that used a single fingertip skin temperature (mean RMSE: 1.39 ± 0.18). When a personalized thermal sensation estimation model based on three wrist skin temperatures was used, the mean RMSE was 1.06 ± 0.29, and the correlation coefficient was 0.89. Thermal sensation estimation technology based on wrist skin temperatures, and combined with wearable devices may facilitate intelligent control of one's thermal environment.

Genetic analysis of ultrasound and carcass measurement traits in a regional hanwoo steer population.

Ultrasound measurements of backfat thickness (UBF), longissimus muscle area (ULMA) and marbling score (UMS) and carcass measurements of carcass weight (CW), backfat thickness (BF), longissimus muscle area (LMA), and marbling score (MS) on 7,044 Hanwoo steers were analyzed to estimate genetic parameters. Data from Hanwoo steers that were raised, finished in Hoengseong-gun, Gangwon-do (province) and shipped to slaughter houses during the period from October 2010 to April 2013 were evaluated. Ultrasound measurements were taken at approximately three months before slaughter by an experienced operator using a B-mode real-time ultrasound device (HS-2000, FHK Co. Ltd., Tokyo, Japan) with a 3.5 MHz linear probe. Ultrasound scanning was on the left side between 13th rib and the first lumbar vertebrae. All slaughtering processes and carcass evaluations were performed in accordance with the guidelines of beef grading system of Korea. To estimate genetic parameters, multiple trait animal models were applied. Fixed effects included in the models were: the effects of farm, contemporary group effects (year-season at the time of ultrasound scanning in the models for UBF, ULMA, and UMS, and year-season at slaughter in the models for CW, BF, LMA, and MS), the effects of ultrasound technicians as class variables and the effects of the age in days at ultrasound scanning or at slaughtering as linear covariates, respectively for ultrasound and carcass measures. Heritability estimates obtained from our analyses were 0.37 for UBF, 0.13 for ULMA, 0.27 for UMS, 0.44 for CW, 0.33 for BF, 0.36 for LMA and 0.54 MS, respectively. Genetic correlations were strongly positive between corresponding traits of ultrasound and carcass measures. Genetic correlation coefficient between UBF and BF estimate was 0.938, between ULMA and LMA was 0.767 and between UMS and MS was 0.925. These results suggest that ultrasound measurement traits are genetically similar to carcass measurement traits.

Osteoporosis Is Associated with an Increased Risk of Colorectal Adenoma and High-Risk Adenoma: A Retrospective, Multicenter, Cross-Sectional, Case-Control Study.

Background/Aims: The protective effects of vitamin D and calcium on colorectal neoplasms are known. Bone mineral density (BMD) may be a reliable biomarker that reflects the long-term anticancer effect of vitamin D and calcium. This study aimed to evaluate the association between BMD and colorectal adenomas including high-risk adenoma. Methods: A multicenter, cross-sectional, case-control study was conducted among participants with average risk of colorectal cancer who underwent BMD and screening colonoscopy between 2015 and 2019. The main outcome was the detection of colorectal neoplasms. The variable under consideration was low BMD (osteopenia/osteoporosis). The logistic regression model included baseline demographics, components of metabolic syndrome, fatty liver disease status, and aspirin and multivitamin use. Results: A total of 2,109 subjects were enrolled. The mean age was 52.1±10.8 years and 42.6% were male. The adenoma detection rate was 43%. Colorectal adenoma and high-risk adenoma were both more prevalent in subjects with low BMD than those with normal BMD (48.2% vs 38.8% and 12.1% vs 9.1%). In the univariate analysis, old age, male sex, smoking, metabolic components, fatty liver, and osteoporosis were significantly associated with the risk of adenoma and high-risk adenoma. In the multivariate analysis, osteoporosis was independently associated with risk of colorectal adenoma (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.11 to 2.46; p=0.014) and high-risk adenoma (OR, 1.94; 95% CI, 1.14 to 3.29; p=0.014). Conclusions: Osteoporosis is an independent risk factor of colorectal adenoma and high-risk adenoma.

Global self-rating of oral health, concerns about oral health, and history of jaw injury related to temporomandibular joint symptoms in Korean adults.

AIMS: To examine the association between temporomandibular joint (TMJ) symptoms and the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction in a representative Korean population. METHODS: From the Korean National Oral Health Survey 2006, 4,546 adults aged 18 years and older were included in the analysis. The dependent variable was TMJ symptoms. The independent variables were the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction. The demographic information (age and gender), socioeconomic status (education level, monthly household income, vocation, and residence), and behavioral factors (recent dental visit and smoking) were evaluated as confounders. Multivariate linear and logistic regression analyses were applied. RESULTS: The overall prevalence of TMJ symptoms in Koreans was 15.3%. The younger, more educated, middle class, those employed in office and sales, and those who resided in city areas had more TMJ symptoms. The TMJ symptoms were significantly associated with the global self-rating of oral health, concerns about oral health, and history of jaw injury. No significant association was found between the TMJ symptoms and a history of a third molar extraction. The global self-rating of oral health, concerns about oral health, and history of jaw injury had a dose-effect relationship with the severity of TMJ symptoms. Age and gender modified the effect of the global self-rating of oral health, concerns about oral health, and the history of jaw injury on TMJ symptoms. CONCLUSION: The global self-rating of oral health, concerns about oral health, and a history of jaw injury might be associated with TMJ symptoms.

The effects of simulation-based learning using standardized patients in nursing students: A meta-analysis.

PURPOSE: The aim of this study was to evaluate the effect of simulation-based learning using standardized patients (SPs) on cognitive, affective, and psychomotor domain outcomes of learning in nursing students. METHODS: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean electronic databases (to June 2014) were searched. The RevMan 5.3 program of the Cochrane library was used for data analysis. RESULTS: A meta-analysis was conducted of 18 controlled trials (4 randomized and 14 non-randomized designs), with a total of 1326 nursing students. Overall, simulation-based learning using SPs appeared to have beneficial effects on the cognitive, affective, and psychomotor domains of learning. In subgroup analysis, use of SPs showed significant effects on knowledge acquisition (d=0.38, p=.05, I(2)=42%), communication skill (d=1.86, p<.001, I(2)=15%), self-efficacy (d=0.61, p<.001, I(2)=6%), learning motivation (d=0.77, p<.001, I(2)=0%) and clinical competence (d=0.72, p<.001, I(2)=0%). Treatment effects on critical thinking (p=.75) and learning satisfaction (p=.43) were not significant. CONCLUSION: The findings of the current study suggest that simulation-based learning using SPs might have a positive impact on self efficacy and learning motivation that affects knowledge and clinical skill acquisition. Therefore, these findings demonstrate that, if integrated appropriately, an SP educational approach can be used in academic settings as an active learning methodology.

[The effects of self development training on the human relationship and intrinsic motivation of the first-line nurse managers].

PURPOSE: The purpose of this study was to examine the effects of Self-Development training on the Human Relationship and Intrinsic Motivation for first-line nurse managers. METHOD: This was an empirical study on the Human Relationship and Intrinsic Motivation of Self Development Training. The researcher developed a new Self-Development Training Program, and the two-hour long training session was performed twice a week for each group. The program was performed for 4 session in two weeks. The subjects consisted with 24 nurse managers from C University Hospital in Seoul, Korea. The subjects were divided into two groups for the training. Two weeks before and 4 weeks after the training, subjects completed questionnaires that measured Human Relationship and Intrinsic Motivation. Analysis was completed by using SPSS PC 10.0 for percentile, mean, standard deviation and paired t-test. RESULT: The results of this study showed that Self-Development Training Program resulted in a significant effects on the Human Relationship. But the Intrinsic Motivation was not significantly affected by the program. CONCLUSION: This Self-Development training program had a positive effect on the Human Relationship and Intrinsic Motivation.

Usefulness of Oxford classification in assessing immunoglobulin A nephropathy after transplantation.

BACKGROUND: We explored the efficacy of the Oxford classification for assessing native immunoglobulin A nephropathy (IgAN) in posttransplantation patients compared with the glomerular injury score and Haas classification. METHODS: A total of 125 renal allograft biopsies obtained from 114 patients diagnosed with IgAN regardless of original disease were assessed. RESULTS: The average time to biopsy was 70.5±45.3 months after transplantation. Glomeruli showed normal histology in 18.4%. Mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), and tubulointerstitial fibrosis (T1-2) were present in 12.8%, 6.4%, 45.6%, and 20.8% of the samples, respectively. There was a significant correlation between Oxford-MEST scores and glomerular injury score or Haas subclass. S1 and T1-2 were correlated with elevated serum creatinine level, proteinuria, and decreased estimated glomerular filtration rate, and E1 was correlated with decreased estimated glomerular filtration rate at the time of biopsy. The 10- and 15-year graft survival rates were 62.9% and 34.3%, respectively. The graft survival rate was significantly lower in the presence of S1 and T1-2. Endocapillary hypercellularity, segmental sclerosis, and tubulointerstitial fibrosis predicted graft survival and endocapillary hypercellularity and tubulointerstitial fibrosis also predicted serum creatinine doubling. CONCLUSIONS: The Oxford classification scheme is useful for evaluating chronic graft dysfunction in patients with posttransplantation IgAN. In addition to tubulointerstitial fibrosis, the presence of endocapillary hypercellularity and segmental sclerosis should be included in the pathology report.

Orthotopic liver transplantation after the combined use of locoregional therapy and sorafenib for advanced hepatocellular carcinoma.

We herein report a patient with advanced hepatitis B virus-related hepatocellular carcinoma (HCC) beyond the Milan criteria. He underwent orthotopic liver transplantation after successful HCC downstaging that satisfied the University of California, San Francisco criteria, using concurrent chemoradiation therapy with a combination of repeated hepatic arterial infusion chemotherapy (HAIC) and sorafenib. A 52-year-old male was diagnosed with advanced hepatitis B virus-related HCC beyond the Milan criteria. He underwent concurrent chemoradiation therapy (50 Gy with 20 fractions over 5 weeks with HAIC using 5-fluorouracil at a dose of 500 mg/day, which was administered during the first and fifth weeks of radiation therapy) as an initial treatment modality. This was followed by the combined use of HAIC using 5-fluorouracil (500 mg/m(2) for 5 hours on days 1-3) and cisplatin (60 mg/m(2) for 2 hours on day 2) every 4 weeks (twelve cycles) and sorafenib (from the third to the twelfth cycle of HAIC) to treat the remaining HCC. Because a remarkable decrease in the tumor burden that satisfied the University of California, San Francisco criteria was observed after these combination treatments, the patient underwent orthotopic liver transplantation with curative aim and survived for 11 months without evidence of HCC recurrence.

Evidence that Vibrio vulnificus ahpC2 is essential for survival under high salinity by modulating intracellular level of ROS.

Expression of ahpC2 encoding an alkyl hydroperoxide reductase of Vibrio vulnificus, a foodborne pathogen, was incrementally induced depending on NaCl concentrations in the culture. Growth of the ahpC2 mutant was significantly impaired with longer lag phase and lower growth rate when cultured under high salinity. ROS was accumulated in V. vulnificus cells when stressed by exposure to high salinity, and the ahpC2 mutant accumulated higher level of ROS as compared with the parental wild type. Consequently, the combined results suggest that AhpC2 contributes to the growth of V. vulnificus under high salinity by scavenging ROS in cells.

[The effects of logotherapy on meaning in life and quality of life of late adolescents with terminal cancer].

PURPOSE: To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer. METHODS: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program. RESULTS: There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups. CONCLUSION: Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.

Identification of the Vibrio vulnificus ahpCl gene and its influence on survival under oxidative stress and virulence.

Pathogens have evolved sophisticated mechanisms to survive oxidative stresses imposed by host defense systems, and the mechanisms are closely linked to their virulence. In the present study, ahpCl, a homologue of Escherichia coli ahpC encoding a peroxiredoxin, was identified among the Vibrio vulnificus genes specifically induced by exposure to H(2)O(2). In order to analyze the role of AhpCl in the pathogenesis of V. vulnificus, a mutant, in which the ahpCl gene was disrupted, was constructed by allelic exchanges. The ahpCl mutant was hypersusceptable to killing by reactive oxygen species (ROS) such as H(2)O(2) and t-BOOH, which is one of the most commonly used hydroperoxides in vitro. The purified AhpCl reduced H(2)O(2) in the presence of AhpF and NADH as a hydrogen donor, indicating that V. vulnificus AhpCl is a NADH-dependent peroxiredoxin and constitutes a peroxide reductase system with AhpF. Compared to wild type, the ahpCl mutant exhibited less cytotoxicity toward INT-407 epithelial cells in vitro and reduced virulence in a mouse model. In addition, the ahpCl mutant was significantly diminished in growth with INT-407 epithelial cells, reflecting that the ability of the mutant to grow, survive, and persist during infection is also impaired. Consequently, the combined results suggest that AhpCl and the capability of resistance to oxidative stresses contribute to the virulence of V. vulnificus by assuring growth and survival during infection.