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This study aimed to examine the effects of auricular acupressure (AA) on sleep and pain among elderly people with osteoarthritis who live in nursing homes.It was a randomized, single-blinded, and placebo-controlled comparative pretest-posttest study that applied AA for eight weeks. The study was conducted among 52 elderly people, comprising an experimental group (n=26), and a control group (n=26). Polysomnography, actigraphy, the levels of melatonin and pressure pain threshold (PPT) were measured. The standardized measurement on sleep quality and pain was also used.Experimental group scores on sleep quality significantly improved as compared to those of the placebo control group. The polysomnography (sleep efficiency, sleep latency, awakening, stage 2 sleep) and the actigraphy (sleep efficiency, sleep latency, number of awakenings) were shown to be significant. The levels of melatonin significantly increased after terminating the intervention. The result of the pain (visual analogue scale) significantly reduced and the PPT significantly increased among the elderly in the experimental groups.AA can be used as an effective intervention to improve their sleep of the elderly living in nursing homes, and it can also reduce the pain.

(1) Background: Various procedures were performed on patients with persistent spinal pain syndrome (PSPS), but the clinical effect and safety were insufficient. The study was to examine the effects of auricular acupressure (AA) on low back pain, neuropathy, and sleep in patients on PSPS. (2) Methods: This was a randomized, single-blind, placebo-controlled study conducted from 1 March 2022 to 31 July 2022. The participants who had at least one lumbar surgery were randomly assigned to either the experimental group (n = 26) or the placebo control group (n = 25). All participants received 6 weeks of AA intervention. To validate the effects of the intervention, pressure pain thresholds (PPT), the Visual Analogue Scale (VAS), douleur neuropathique 4 (DN4) questions, the Pittsburgh Sleep Quality Index (PSQI), and actigraphy with a Fitbit Alta were conducted. The data were analyzed with SPSS/WIN ver. 27.0, using a t-test and repeated-measures ANOVA. (3) Results: The findings showed that there were significant differences in pain (back VAS p = 0.003, leg VAS p = 0.002, PPT p = 0.008), neuropathy (DN4 p = 0.034), and sleep actigraphy (sleep efficiency p = 0.038, number of awake p = 0.001, deep sleep stage p = 0.017). (4) Conclusions: We conclude that AA is an effective, safe, cost-effective, non-invasive nursing intervention that can improve pain, neuropathy, and sleep in patients on PSPS.

Purpose: This study was done to examine the effects of auricular acupressure (AA) on blood pressure (BP) and stress responses in adults with prehypertension.Methods: This single-blind, randomized, placebo-controlled study was conducted from September 2019 to February 2020. Participants were recruited through bulletin board notices in D city. The experimental group (n=27) received 8 weeks of AA intervention on specific acupoints (shenmen, kidney, heart, occiput, adrenal gland) to reduce blood pressure and stress, whereas the control group (n=25) received AA unspecific acupoints (helix 1-5). The outcomes were measured using BP, perceived stress scale (PSS), cortisol, and heart rate variability (HRV). Collected data were analyzed using Fisher’s exact test, chi-square, Shapiro-Wilk normality test, paired t-test, independent t-test, Mann-Whitney U test, repeated measures ANOVA and Friedman test with the SPSS/WIN 24.0.Results: Statistical differences were found between the groups for systolic BP (x2=85.64, p2=27.76, p=.001), PSS (F=9.439, p=.003), low frequency (F=5.22, p=.027), heart rate (F=3.208, p=.045), and HRV index (F=3.579, p=.035). Cortisol did not differ significantly between the experimental group and control group.Conclusion: The findings show that AA leads to improvements in BP and stress responses in adults with prehypertension. Therefore, AA can be used as an alternative nursing intervention for hypertension prevention and stress management.

This study aimed to investigate the activity of a nutrition support team (NST) and the trends of multi-chamber bag (MCB) and customized parenteral nutrition (PN) with NST consultations in South Korea. Data were obtained from the National Inpatient Sample Cohort between 2015 and 2020. Three datasets were constructed for NST consultation, MCB-PN product prescriptions, and aseptic preparation of total PN. The intersections of the NST consultation and each PN dataset were compiled into MCB-PN with NST or customized PN with a NST sub-dataset, respectively. Using personal identifiers, the patients’ characteristics were evaluated in the NST cohort. A total of 91,384 reimbursements and 70,665 patients were included. The NST activity had increased by more than 50% over 6 years. Approximately 70% and 11%, respectively, of the NST cohort were classified into two subgroups: MCB-PN with NST (M-NST) and customized PN with NST (C-NST). M-NST had many elderly patients with cancer and showed a higher in-hospital mortality than C-NST (12.6% vs. 9.5%). C-NST included a larger number of patients under the age of 5 years, and the hospitalization period was more extended than M-NST (26.2 vs. 21.2 days). The present study showed that NST activities and the proportion of PN with NST consultation are gradually increasing in South Korea.

Purpose: The aim of this study was to evaluate the effects of auricular acupressure on sleep quality and pruritus in patients undergoing hemodialysis and to propose an effective and evidence-based nursing intervention.Methods: This was a single-blind, nonequivalent, group comparison study with 42 participants. The experimental period was a total of 8 weeks, and five different acupressure sites were applied in each group. Dependent variables were measured before the intervention, at the 4th week of the intervention, and at the 8th week of the intervention.Results: There were significant differences in the Pittsburgh sleep quality index, total sleep time, sleep efficiency, sleep onset latency, light sleep, deep sleep, number of awakenings, serum melatonin levels, subjective pruritus and skin hydration. No significant difference was found in skin pH between the two groups. Conclusion: Auricular acupressure was found to be an effective nursing intervention to improve sleep quality and to reduce pruritus in patients undergoing hemodialysis.

Background Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease mediated by T helper type 2 (Th2) cells in acute phase. Group 2 innate lymphoid cells (ILCs) play a role in the initiation of the Th2 response. Although mold exposure is associated with the development of AD, studies on the underlying mechanisms are lacking. This study investigated whether group 2 ILCs are involved in inflammation in AD-like skin induced by Aspergillus fumigatus (Af). Methods We investigated changes of group 2 ILCs population in Af-induced AD-like skin lesions. To induce AD-like skin lesions, Af extracts were applied to the dorsal skin of BALB/c and Rag1−/− mice five times per week, with repeat exposures at 2-week intervals. Results The clinical parameters were higher in the Af-treated group than in the control group. Histologic findings revealed epiderrmal and dermal thickening as well as eosinophil and mast cell infiltration into the skin of Af-treated mice. Populations of group 2 ILCs in the skin were also significantly higher in the Af-treated group. In addition, interleukin-33 mRNA expression was significantly higher in the skin lesions of the Af-treated mice. In the Rag1−/− mice lacking mature lymphocytes, AD-like skin lesions were still induced by Af and ILCs depletion using an anti-CD90.2 mAb lowered the Af-induced inflammatory response. Conclusions Group 2 ILCs may play a role in a murine model of Af-induced AD-like skin lesions.

Background Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease mediated by T helper type 2 (Th2) cells in acute phase. Group 2 innate lymphoid cells (ILCs) play a role in the initiation of the Th2 response. Although mold exposure is associated with the development of AD, studies on the underlying mechanisms are lacking. This study investigated whether group 2 ILCs are involved in inflammation in AD-like skin induced by Aspergillus fumigatus (Af). Methods We investigated changes of group 2 ILCs population in Af-induced AD-like skin lesions. To induce AD-like skin lesions, Af extracts were applied to the dorsal skin of BALB/c and Rag1-/- mice five times per week, with repeat exposures at 2-week intervals. Results The clinical parameters were higher in the Af-treated group than in the control group. Histologic findings revealed epiderrmal and dermal thickening as well as eosinophil and mast cell infiltration into the skin of Af-treated mice. Populations of group 2 ILCs in the skin were also significantly higher in the Af-treated group. In addition, interleukin-33 mRNA expression was significantly higher in the skin lesions of the Af-treated mice. In the Rag1-/- mice lacking mature lymphocytes, AD-like skin lesions were still induced by Af and ILCs depletion using an anti-CD90.2 mAb lowered the Af-induced inflammatory response. Conclusions Group 2 ILCs may play a role in a murine model of Af-induced AD-like skin lesions.

Baraitser-Winter Cerebro-fronto-facial syndrome (BWCFF, OMIM #243310, #614583) is caused by a heterozygous gain-of-function mutation of

BACKGROUND Distant relapse is the leading cause of cancer-related death in locally advanced rectal cancer. Neoadjuvant chemoradiation (NACRT) followed by surgery inevitably delays delivery of systemic treatment. Some patients show early distant metastasis before systemic treatment. AIM To identify the most effective treatments. We investigated prognostic factors for distant metastasis, especially early distant metastasis, using the standard treatment paradigm to identify the most effective treatments according to recurrence risk. METHODS From January 2015 through December 2019, rectal cancer patients who underwent NACRT for having clinical T 3-4 or clinical N 1-2 disease according to the 8th American Joint Committee on Cancer staging system were included. Radiotherapy was delivered to the whole pelvis with concomitant chemotherapy. Patients received surgery 6-8 wk after completion of NACRT. Adjuvant chemotherapy was administered at the physician’s discretion. RESULTS A total of 127 patients received NACRT. Ninety-three patients (73.2%) underwent surgery. The R0 resection rate was 89.2% in all patients. Pathologic tumor and node downstaging rates were 41.9% and 76.3%. Half the patients (n = 69) received adjuvant chemotherapy after surgery. The 3-year distant metastasis-free survival (DMFS) and overall survival (OS) rates were 81.7% and 83.5%. On univariate analyses, poorly differentiated tumors, > 5 cm, involvement of mesorectal fascia (MRF), or presence of extramural involvement (EMVI) were associated with worse DMFS and OS. Five patients showed distant metastasis at their first evaluation after NACRT. Patients with early distant metastasis were more likely to have poorly differentiated tumor (P = 0.025), tumors with involved MRF (P = 0.002), and EMVI (P = 0.012) than those who did not. CONCLUSION EMVI, the involvement of MRF, and poor histologic grade were associated with early distant metastasis. In order to control distant metastasis and improve treatment outcome, selective use of neoadjuvant treatment according to individualized risk factors is necessary. Future studies are required to determine effective treatment strategies for patients at high risk for distant metastasis.

Background Immune checkpoint inhibitors (ICI) have become an important treatment option for non-small cell lung cancer (NSCLC). We aimed to evaluate the clinical impact of pseudoprogression (PsP) and treatment beyond RECIST1.1-defined progressive disease (TBP) on outcome in NSCLC patients treated with ICI. Methods NSCLC patients treated with ICI between Mar 2016 and July 2018 were recruited in a consecutive manner. Response was assessed every 8–12 weeks using RECIST1.1 and iRECIST. Based on iRECIST, PsP was defined as progressive disease (PD) on RECIST1.1 subsequently reset to non-PD categories. Using log-rank test, progression-free survival (PFS) was compared between patients with and without PsP, and overall survival (OS) was compared between patients treated with and without TBP. The impact of TBP on OS was evaluated through multivariate Cox proportional hazard models. Results Of the 189 patients, seven (3.7%) experienced PsP which mostly occurred approximately 3 months after baseline. The median PFS was significantly longer in patients with PsP (not reached) than those without PsP (3.8 months, P = .02). Among patients who demonstrated PD according to RECIST1.1, median OS was significantly longer in patients with TBP (17.2 months) than those without TBP (7.4 months, P

Background Primary sebaceous carcinoma of lacrimal gland (SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chance of local recurrence and metastasis. We report a case of primary SCLG. Case summary A 75-year-old man was referred with a painful swelling in the right eyelid. Computed tomography scan demonstrates a 2.6 cm mass in upper outer quadrant of right orbit. After the incisional biopsy of the mass, he was diagnosed with squamous cell carcinoma of lacrimal gland. A right orbital exenteration, cervical lymph node dissection was performed. There was no involvement of the overlying periorbital skin, eyelid, or conjunctiva. Histological examination of the exenteration specimen showed tumor arising from the lacrimal gland, which had been entirely replaced by sebaceous carcinoma with sarcomatous and squamous differentiation. Neoplastic cells which were large and contained prominent nucleoli. Focal tumor remained in the posterior resection margin. Patient underwent adjuvant radiotherapy, total dose of 56 Gy with dose-per-fraction 2 Gy to primary lesion. There has been no sign of recurrence until 2-years follow-up. Conclusion We report a rare case of sebaceous carcinoma arising from the lacrimal gland. Accurate diagnosis of SCLG is important for appropriate treatment and prognosis prediction.

The treatment efficacy of immune checkpoint inhibitors (ICIs) in colorectal cancer (CRC) has been reported heterogeneously across clinical trials. We conducted a systematic review and meta-analysis to evaluate the efficacy of ICIs in patients with advanced/metastatic CRC. Ovid-Medline was searched to identify clinical trials providing the efficacy outcomes of overall response rate (ORR) or disease control rate (DCR). The pooled ORR and DCR were estimated across all studies and subgroups. Meta-regression was performed to find the influencing factors for treatment efficacy. A total of thirty studies (1870 patients) were eligible. The overall ORR and DCR were 20.1% and 58.5%, respectively, but these results were heterogeneous across studies. Multivariate meta-regression revealed that microsatellite phenotype (odds ratio of MSI-H/dMMR versus MSS/pMMR: 1.67, p &lt, 0.001) and drug regimen (odds ratio of monotherapy versus combination therapy: 1.07, p = 0.019) were the source of heterogeneity and also significantly influenced factors for the efficacy of the treatment. Although the efficacy of ICIs as a first-line therapy was higher than that of ICIs as the second- or more-line therapy (ORR: 51.5% vs. 13.4%, DCR: 85% vs. 49.5%), multivariate regression showed that the line of therapy was not a significant factor for the treatment efficacy. Our study suggests that the microsatellite phenotype and drug regimen, rather than the line of treatment, are the primary factors influencing the treatment response among advanced/metastatic CRC patients treated with an ICI-based regimen.

Biological systems often generate unique and useful structures, which can have industrial relevance either as direct components or as an inspiration for biomimetic materials. For fabrication of nanoscale silica structures, we explored the use of the silaffin R5 peptide from Cylindrotheca fusiformis expressed on the surface of the fd bacteriophage. By utilizing the biomineralizing peptide component displayed on the bacteriophage surface, we found that low concentrations (0.09 mg/mL of the R5 bacteriophage, below the concentration range used in other studies) could be used to create silica nanofibers. An additional benefit of this approach is the ability of our R5-displaying phage to form silica materials without the need for supplementary components, such as aminopropyl triethoxysilane, that are typically used in such processes. Because this method for silica formation can occur under mild conditions when implementing our R5 displaying phage system, we may provide a relatively simple, economical, and environmentally friendly process for creating silica nanomaterials.

This study examined the effects of source and crisis response strategy on crisis communication outcomes in the context of social media. A 3 (source: organization, CEO, or customer) × 2 (strategy: accommodative or defensive) × 2 (crisis type: airline crash or bank hacking) mixed experimental study was conducted with 391 participants. The organizational sources were more likely to be perceived as more credible than the non-organizational sources. In particular, the CEO appeared to be the most trustworthy and credible source in delivering crisis messages. The path analysis indicated that perceived source credibility mediated the effect of source on reputation and behavioral intentions. This mediation appeared to be contingent on the type of crisis response strategy.

Background Atopic dermatitis (AD) is a chronic and relapsing inflammatory skin disease. Great efforts have been recently made to treat AD using mesenchymal stem cells (MSCs), which have immunomodulatory functions. However, the immunomodulatory effects of MSCs need to be enhanced for clinical application in the treatment of AD. Objectives To evaluate and characterise the therapeutic effects of human Wharton’s jelly-derived MSCs (WJ-MSCs) primed with the Toll-like receptor 3 agonist poly I:C or interferon-γ (IFN-γ) in a murine model of AD. Methods Mice were treated with Aspergillus fumigatus extract to induce AD and then subcutaneously injected with non-primed, poly I:C-primed or IFN-γ-primed WJ-MSCs. Clinical symptom scores, transepidermal water loss (TEWL), histological characteristics and cytokine levels were determined. Transcriptome profiling and pathway analyses of primed WJ-MSCs were conducted. Results The clinical symptom score and TEWL in skin lesions were reduced in mice administered non-primed and primed WJ-MSCs. Epidermal thickness and inflammatory cell infiltration in skin lesions were reduced more in mice administered primed WJ-MSCs than in mice administered non-primed WJ-MSCs. Secretion of interleukin-17 was significantly reduced in skin draining lymph nodes of mice administered primed WJ-MSCs. Genomics and bioinformatics analyses demonstrated the enrichment of certain pathways specifically in WJ-MSCs primed with poly I:C or IFN-γ. Conclusions Priming with poly I:C- or IFN-γ improved the therapeutic effects of WJ-MSCs in a murine model of AD. This study suggests that priming with poly I:C or IFN-γ enhances the immunomodulatory functions of WJ-MSCs and can be used as a novel therapeutic approach for AD. Electronic supplementary material The online version of this article (10.1186/s13287-019-1164-6) contains supplementary material, which is available to authorized users.

BACKGROUND Transcatheter device closure of ventricular septal defect (VSD) has become an attractive alternative to surgery. We report here on our early experiences of transcatheter closure of VSD using Cocoon devices, which are now available in Korea. METHODS We reviewed the medical records and angiographic images of 13 patients who underwent transcatheter closure of VSD with a Cocoon occluder at Samsung Medical Center. The median patient age was 5.8 years, and the median patient weight was 20.3 kg. RESULTS The device was successfully implanted in all patients. The follow-up period was 10 ± 6 months, and no mortality was observed. An immediate residual leak on the next day was detected in 7 patients (including 4 with perimembranous VSD). However, 6 months later, a residual leak was observed only in 2 patients with perimembranous VSD and 1 patient with muscular VSD. Early conduction abnormalities were observed in 3 patients, all of whom had perimembranous VSD, but no significant complete atrioventricular block was observed. One patient experienced newly developed significant aortic regurgitation that decreased spontaneously but still existed at the 6 month follow-up. No hemolysis or embolization was noted on the next day or during the follow-up period. CONCLUSIONS Cocoon devices can be used safely and effectively for VSD closure. However, residual leaks and conduction abnormalities may occur early after implantation, especially in patients with perimembranous VSD. Although normal conduction was recovered, long-term evaluation remains essential.

The purpose of this study was to develop and test a semantic differential scale of sexual attitudes for older people in Korea. The scale was based on items derived from a literature review and focus group interviews. A methodological study was used to test the reliability and validity of the instrument. A total of 368 older men and women were recruited to complete the semantic differential scale. Fifteen pairs of adjective ratings were extracted through factor analysis. Total variance explained was 63.40%. To test for construct validity, group comparisons were implemented. The total score of sexual attitudes showed significant differences depending on gender and availability of sexual activity. Cronbach's alpha coefficient for internal consistency was 0.96. The findings of this study demonstrate that the semantic differential scale of sexual attitude is a reliable and valid instrument.

Purpose: The purpose of this study was to investigate knowledge of cervical cancer, HPV and intention for vaccination in Korean soldiers on active duty. Methods: Participants were 494 army men aged 18 to 26 serving in D area. Knowledge of cervical cancer was measured using the 8 item scale developed by Han et al. (2007) and knowledge of HPV was measured using the 13 item scale developed by Pitts et al. (2009). Collected data were analyzed with t-test, -test, and ANOVA. Results: Mean scores for cervical cancer and HPV knowledge were and respectively and vaccination intention was 75.6%. HPV vaccination intention had significant differences depending on knowledge about cervical cancer (${\chi}^2

Aims: Lipopolysaccharide (LPS) is considered a prominent pathogenic factor in inflammatory bone diseases. LPS challenge contributes to the production of reactive oxygen species (ROS) in diverse inflammatory diseases. However, its mechanism remains to be clarified in bone. Thus, we investigated the critical mechanism of ROS in LPS-induced osteoclastogenesis and bone loss. Results: Antioxidant prevented LPS-induced osteoclast formation via inhibition of nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1) and c-Fos expression in preosteoclasts. Moreover, LPS-induced osteoclast formation via ROS was attenuated by treatment with c-Jun N-terminal protein kinase (JNK) inhibitor. Interestingly, LPS also activated signal transducer and activator of transcription 3 (STAT3), which is suppressed by antioxidants. We found that knockdown of STAT3 or use of a STAT3 inhibitor resulted in a significant reduction in interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and nitric oxide (NO) production, followed by decreased osteoclast formation by LPS. Peroxiredoxin II (PrxII) is a member of the antioxidant enzyme family, and it plays a protective role against oxidative damage caused by ROS. In our study, ROS production and osteoclast formation by LPS was significantly enhanced in PrxII−/− cells. Moreover, JNK-mediated c-Fos and NFATc1 expression was promoted in PrxII−/− cells. Furthermore, STAT3 activation and accompanying IL-1β, IL-6, and NO production was also increased in PrxII−/− cells. Consistent with the in vitro result, PrxII-deficient mice showed increased osteoclast formation and bone loss by LPS challenge compared with wild-type mice. Innovation: For the first time, we showed that LPS-induced ROS signaling is dependent on the coordinated mechanism of JNK and STAT3 during osteoclastogenesis, which is negatively regulated by PrxII. Conclusion: We suggest that PrxII could be useful in the development of a novel target for inflammatory bone loss. Antioxid. Redox Signal. 22, 63–77.

경제수준의 향상, 인구의 노령화, 생활습관의 변화와 운동부족으로 인한 비만 인구의 증가 등은 질병의 만성화를 가속화시키고 있으며 이로 인하여 당뇨병 환자의 유병률도 꾸준히 증가하는 추세이다. 세계보건기구 자료에 의하면 전 세계 당뇨병 환자가 현재 3억 6천만명 정도에서 2030년도까지 5억 5천만명 정도로 증가될 것으로 예측하고 있고 (World Health Organization [WHO], 2012), 국내에서도 현재 성인 10명 중 1명이 당뇨병 환자(당뇨병 유병률 10.1%)이며, 성인 10명 중 2명이 당뇨병 전단계(공복혈당장애 유병률 19.9%)로 성인 10명 중 3명은 당뇨병 환자 및 잠재적 당뇨병 환자로 조사되었다 . 현재 당뇨병 유병률을 고려할 때 2050년 우리나라 당뇨병 환자 수는 약 600만명으로 추정되며, 이는 2010년 기준 183% 증가한 수치이다. 당뇨병으로 인한 사망률도 인구 10만명당 21.5명으로 10대 사망원인 순위에서 2008년 이후 꾸준히 5위를 차지하면서 높은 사망률을 보이고 있고 (Korea National Statistical Office [KNSO], 2012), 2010-2012년 국민건강영양조사에서 만 30세 이상 당뇨병 유병자의 당뇨병 관리수준을 조사한 결과, 당뇨병의 인지율이 73.2%이나 치료율은 61.0%로 나타나(Ministry for Health, Welfare and Family Affairs [MHWFA], 2012), 당뇨병의 올바른 관리가 중요한 보건문제임을 시사하고 있다. 또한 2007년부터 2010년도 국민건강영양조사를 바탕으로 대한당뇨병학회 진료지침에 근거해 당화혈색소를 6.5% 미만으로 정의하여 조사한 결과 당뇨병 환자 중 혈당조절 목표에 도달한 환자는 29.5%에 불과하였다. 미국당뇨병학회 기준인 7% 미만을 적용하더라도 50.6%로 약 절반만이 혈당조절이 양호한 상태인 것으로 조사되어 (KNSO, 2012), 당뇨병 환자의 절반이상이 혈당조절이 되지 않는 것으로 나타났다. 당뇨병 환자의 유병율과 사망률을 낮추고 건강한 삶을 영위하기 위해 당뇨 관리를 위한 지식습득은 상당히 중요하다 . 당뇨병 환자의 질병에 대한 지식 없이는 행위변화를 기대하기 어렵고, 당뇨병 자가관리교육은 환자의 결과를 개선시키기 위한 필수적인 요소이다(Funnell et al., 2010). 그런데 선행연구에서 당뇨 지식과 자가간호행위가 상관관계가 있음을 보고한 연구들이 있는 반면(Al-Maskari et al., 2013; Choi & Jung, 2010; Tahmasebi, Noroozi, & Tavafian, 2013) 당뇨병 환자의 당뇨 지식과 자가간호행위가 유의한 상관관계가 없다고 보고한 연구도 있다(Lee, 2003; Xu, Toobert, Savage, Pan, & Whitmer, 2008). 또한 자가간호행위가 당뇨병 환자의 당화혈색소에 긍정적인 영향을 미칠 수 있고(Al-Khawaldeh, Al-Hassan, & Froelicher, 2012; Kim & Kang, 2008; Park, 2010), 당뇨 지식도 당화혈색소에 바람직한 결과를 제공하는 것으로 나타났으나(Lee, Kang, & Kim, 2008), 당화혈색소가 당뇨병 환자의 당뇨 지식이나 자가간호행위와 유의하지 않다는 결과도 있었다(Al-Maskari et al., 2013; Lee, 2003). 이와 같이 선행 연구의 결과를 살펴보면 당뇨병 환자의 당뇨 지식, 자가간호행위와 당화혈색소의 관계가 일관되지 않은 연구 결과들을 보이고 있으므로 이에 대한 지속적인 후속연구가 필요하다. 또한 다른 어느 만성질병보다 특히 당뇨병은 질병관리를 도와주는 사람이 없는 경우 자가간호행위에 부정적인 영향을 미치게 되고(Choi, Jang, & Nam, 2008), 사회적 지지와 가족의 지지는 당뇨병 자가관리 이행에 긍정적인 영향을 미친다고(Tahmasebi et al., 2013; Tang, Brown, Funnell, & Anderson, 2008) 보고되고 있음에도 지금까지의 당뇨병 환자대상 연구들이 주로 대학병원이나 보건소에서 이루어졌고 공공병원에서의 조사연구는 없었다. 이에 본 연구는 자가간호행위를 수행하는데 어려움이 예측되는 저소득층 환자와 독거 주민이 주로 방문하는 공공병원 중, 2009년 내과외래 방문환자의 30.7%가 의료급여 대상자로 타 의료기관의 2∼11% 수준(Kim, 2013)에 비해 상당한 비중을 차지하고 있는 서울시 소재 S의료원을 세팅으로 당뇨병 환자의 당뇨지식, 자가간호행위와 당화혈색소의 관계를 파악함으로써 공공병원 이용 대상자에게 효과적인 당뇨교육 중재프로그램의 기초자료를 제공하고자 시행되었다.

Purpose: The purpose of this research was to assess the methodological quality of non-randomized studies published in the Journal of Korean Fundamentals of Nursing. Methods: A search of non-randomized studies assessing intervention effects was conducted among all articles published in the Journal of Korean Fundamentals of Nursing between 2011 and 2013. Articles were assessed for quality using the Methodological Index for Non Randomized Studies (MINORS). For each index item, the frequency and percentage of articles meeting the criteria were calculated, along with mean scores by research method, publication year, and research topic. Results: A total of 22 studies were included. The mean score for studies without control groups was 11.75 (range 0-16), and for those with control groups, 19.27 (range 0-24). Results show that improvement is needed on several items: "endpoints appropriate to the aim of the study," "unbiased assessment of the study endpoint," "follow-up period appropriate to the aim of the study," "loss to follow up less than 5%," and "contemporary groups." Conclusion: Although the quality of articles published in the Journal of Korean Fundamentals of Nursing has consistently increased, more emphasis should be placed on using rigorous research methods.

Growing evidence shows the possibility of a role of microRNAs (miRNA) in regulating bone mass. We investigated the change of miRNAs and mRNA expression profiles in bone tissue in an ovariectomized mice model and evaluated the regulatory mechanism of bone mass mediated by miRNAs in an estrogen-deficiency state. Eight-week-old female C3H/HeJ mice underwent ovariectomy (OVX) or sham operation (Sham-op), and their femur and tibia were harvested to extract total bone RNAs after 4 weeks for microarray analysis. Eight miRNAs (miR-127, -133a, -133a*, -133b, -136, -206, -378, -378*) were identified to be upregulated after OVX, whereas one miRNA (miR-204) was downregulated. Concomitant analysis of mRNA microarray revealed that 658 genes were differentially expressed between OVX and Sham-op mice. Target prediction of differentially expressed miRNAs identified potential targets, and integrative analysis using the mRNA microarray results showed that PPARγ and CREB pathways are activated in skeletal tissues after ovariectomy. Among the potential candidates of miRNA, we further studied the role of miR-127 in vitro, which exhibited the greatest changes after OVX. We also studied the effects of miR-136, which has not been studied in the context of bone mass regulation. Transfection of miR-127 inhibitor has enhanced osteoblastic differentiation in UAMS-32 cells as measured by alkaline phosphatase activities and mRNA expression of osteoblast-specific genes, whereas miR-136 precursor has inhibited osteoblastic differentiation. Furthermore, transfection of both miR-127 and miR-136 inhibitors enhanced the osteocyte-like morphological changes and survival in MLO-Y4 cells, whereas precursors of miR-127 and -136 have aggravated dexamethasone-induced cell death. Both of the precursors enhanced osteoclastic differentiation in bone marrow macrophages, indicating that both miR-127 and -136 are negatively regulating bone mass. Taken together, these results suggest a novel insight into the association between distinct miRNAs expression and their possible role through regulatory network with mRNAs in the pathogenesis of estrogen deficiency-induced osteoporosis.