PURPOSE: The purpose of this study was to elucidate nursing performance to superior's ethical leadership as perceived by nurses and the mediating effect of faith in supervisor. METHODS: For this study a descriptive survey design was used. Participants were 258 nurses who worked in general hospital and completed the self-report questionnaire. Data were collected from May 17 to May 31, 2017 and were analyzed using independent t-test, ANOVA, Scheffé test, and Path analysis with SPSS 22.0 and AMOS 21.0. RESULTS: Superior's ethical leadership as perceived by the nurses and faith in the supervisor were significant variables predicting the level of nursing performance and accounted for 48.1% of the variance. Faith in the supervisor as a mediator was found to have a partial mediating effect. CONCLUSION: In order to improve the nurses' performance, it is important to establish a work environment so that hospital nurses can perform their work with faith in their supervisors, as well as having superiors who are ethical leaders.
Hospitals, General ; Leadership* ; Negotiating* ; Nursing* ; Nursing, Supervisory

Hashimoto's encephalopathy is a steroid responsive relapsing disorder associated with high titers of thyroid-related autoantibodies that presents with subacute progressive dementia and myoclonus. Although most patients reported have been either euthyroid or hypothyroid at the time of presentation, we present a patient with Hashimoto's encephalopathy with thyrotoxicosis that was successfully managed with steroids and antihyperthyroid therapy. We recommend that encephalopathy presented in patients with hyperthyroidism should be tested with thyroid-related autoantibodies and managed with steroid and antihyperthyroid therapy.
Autoantibodies ; Dementia ; Humans ; Hyperthyroidism ; Myoclonus ; Steroids ; Thyrotoxicosis

Given the CYP3A4 and CYP3A5's impact on the efficacy of drugs, the genetic backgrounds of individuals and populations are regarded as an important factor to be considered in the prescription of personalized medicine. However, genetic studies with Korean population are relatively scarce compared to those with other populations. In this study, we aimed to identify CYP3A4/5 polymorphisms and compare the genotype distributions among five ethnicities. To identify CYP3A4/5 SNPs, we first performed direct sequencing with 288 DNA samples which consisted of 96 Koreans, 48 European-Americans, 48 African-Americans, 48 Han Chinese, and 48 Japanese. The direct sequencing identified 15 novel SNPs, as well as 42 known polymorphisms. We defined the genotype distributions, and compared the allele frequencies among five ethnicities. The results showed that minor allele frequencies of Korean population were similar with those of the Japanese and Han Chinese populations, whereas there were distinct differences from European-Americans or African-Americans. Among the pharmacogenetic markers, frequencies of CYP3A4*1B (rs2740574) and CYP3A5*3C (rs776742) in Asian groups were different from those in other populations. In addition, minor allele frequency of CYP3A4*18 (rs28371759) was the highest in Korean population. Additional in silico analysis predicted that two novel non-synonymous SNPs in CYP3A5 (+27256C>T, P389S and +31546T>G, I488S) could alter protein structure. The frequency distributions of the identified polymorphisms in the present study may contribute to the expansion of pharmacogenetic knowledge.
Asian Continental Ancestry Group ; Computer Simulation ; Cytochrome P-450 Enzyme System ; DNA ; Gene Frequency ; Genotype ; Humans ; Precision Medicine ; Mass Screening* ; Pharmacogenetics ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Prescriptions

OBJECTIVES: Currently established first line therapy of acute (presumed bacterial) rhinosinusitis (ARS) consists of 10 to 14 days of oral amoxicillin or cephalosporins. This study compared the clinical efficacy and tolerance of cefcapene pivoxil (CP) and amoxicillin-clavulanate (AMC) in patients with ARS. METHODS: A randomized, open labeled, double-blinded trial of ARS patients over 15 years of age was performed. Patients diagnosed with ARS received paranasal sinus X-rays and nasal endoscopies and 2 weeks of either CP (150 mg, 3 times/ day) or AMC (625 mg, amoxicillin 500 mg, 3 times/day). All patients revisited the clinic on days 7, 14, and 28 for evaluation of changes in symptoms, endoscopy, and monitoring of any adverse reactions. Demographics, clinical characteristics and drug efficacy were also compared between the two groups. RESULTS: Among the 60 initially enrolled patients (CP 30, AMC 30), 5 patients in the CP group and 6 in the AMC group were excluded due to poor compliance. There were no significant differences in demographic data including age, sex, initial signs and symptoms, endoscopic and X-ray findings between the two groups. Rates of improvement after 2 weeks were 96% and 95.8% in the CP and AMC group, respectively. Sinus symptoms were changed significantly after 2 and 4 weeks, however, there was no difference between groups (P=0.41). The most common adverse reaction was gastrointestinal complication, diarrhea occurred in 1 patient in the CP group and 6 in the AMC group (P=0.04). CONCLUSION: CP and AMC were both effective in treating ARS. The difference of treatment outcome was not found between the two groups, however, gastrointestinal complications were less prevalent in the CP group.
Amoxicillin ; Amoxicillin-Potassium Clavulanate Combination ; Bacterial Infections ; Cephalosporins ; Clavulanic Acid ; Compliance ; Demography ; Diarrhea ; Double-Blind Method ; Endoscopy ; Humans ; Sinusitis ; Treatment Outcome

Apoptotic cell death induced by p53 occurs at a late G1 cell cycle checkpoint termed the restriction(R)point, and it has been proposed that p53-induced apoptosis causes upregulation of CD95. However, as cells with defective in CD95 signaling pathway are still sensitive to p53-induced apoptosis, CD95 cannot be the sole factor resulting in apoptosis. In addition, unlike p53-induced apoptosis, the relationship between CD95-mediated apoptosis and the cell cycle is not clearly understood. It would there-fore be worth investigating whether CD95-mediated cell death is pertinent with p53-induced apoptosis in view of cell cycle related molecules. In this report, biochemical analysis showed that etoposide-induced apoptosis caused the induction and the nuclear translocation of effector molecules involved in G1 cell cycle checkpoint. However, there was no such translocation in the case of CD95-mediated death. Thus, although both types of apoptosis involved caspase activation, the cell cycle related proteins responded differently. This argues against the idea that p53-induced apoptosis occurs through the induction of CD95/CD95L expression.
Active Transport, Cell Nucleus ; Antigens, CD95/*metabolism ; *Apoptosis ; Cell Cycle ; Cell Nucleus/metabolism ; Coculture ; Dose-Response Relationship, Drug ; Down-Regulation ; Etoposide/pharmacology ; Flow Cytometry ; Human ; Immunoblotting ; Jurkat Cells ; Nucleic Acid Synthesis Inhibitors/pharmacology ; Protein Binding ; Protein Transport ; Protein p53/*metabolism ; Signal Transduction ; Up-Regulation

In 1960 Martin and his associates described another type of tumor of the stomach derived from the smooth muscle, which they named myoid tumor in a study of six patients. In 1962 Stout applied the term "lelomyoblastoma" to this interesting entity in a report of a collected series of 69 patients. Tumor cells are round or polygonal epithelioid cells, which contain perinuclear vacuole or clear zone. A 58 year-old female was admitted to this hospital because of epigastric discomfort for three months. At Upper gastrointestinal series and gastrofiberscope, a round hemispherical submucosal tumor was noted at posterior wall near the lesser curvature of gastric antrum. After subtotal gastrectomy, the submucosal tumor was diagnosed as leiomyoblastoma. Because leiomyoblastoma are rare and easily misdiagnosed as leiomyoma or leiomyosarcoma, careful histologic study is recommended.
Epithelioid Cells ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyoma, Epithelioid* ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Pyloric Antrum ; Stomach* ; Vacuoles

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, classically was considered a exceedingly rare obstetrical phenomenon. But nowadays the natural incidence is increasing and especially in association with assisted reproductive technologies, such as use of variable methods for ovulation inductions, in-vitro fertilization and embryo transfer, and gamate intrafallopian transfer. In spite of the difficult early diagnosis, which is potentially dangerous to the mother and fetus, the maternal mortality, morbidity and fetal loss is low when the diagnosis is made in timely fashion and proper management is achieved. The presence of a intrauterine pregnancy dose not exclude the possibility of a extrauterine pregnancy, and in women associated with assisted reproductive technologies, the possibility of a heterotopic pregnancy should be considered. We report a case of a heterotopic pregnancy following ovulation induction and intrauterine insemination with brief review of literature.
Diagnosis ; Early Diagnosis ; Embryo Transfer ; Female ; Fertilization ; Fetus ; Humans ; Incidence ; Insemination ; Maternal Mortality ; Mothers ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted

OBJECTIVE: Mirtax is a generic mirtazapine widely used since 2003. We conducted an open-label, uncontrolled 6-week study to evaluate the efficacy and safety of Mirtax for major depressive disorder (MDD). METHODS: Ninety three MDD patients with the diagnosis of MDD and 17-item Hamilton Depression Rating Scale (HDRS) score > or =14 were recruited. The HDRS, Montgomery-Asberg Depression Rating Scale (MADRS), and the Clinical Global Impressions-Severity Scale (CGI-S) were administered at baseline, 1, 2, 4 and 6 weeks. Response (> or =50% decrease in the HDRS or MADRS score), remission (absolute HDRS score < or =7 or MADRS score < or =10) and CGI-I score < or =2 were also calculated. Adverse event (AE) frequency and severity, weight, blood pressure, and pulse rate were checked to assess safety. RESULTS: The starting dosage was 11.5+/-6.4 mg/day, and the maintenance dosage was 23.1+/-9.4 mg/day. During 6 weeks, HDRS, MADRS and CGI-S scores decreased from 25.1+/-5.6 to 11.9+/-8.6 (mean change -13.1+/-8.3, p<0.001), from 30.2+/-6.3 to 13.73+/-10.40 (mean change -16.5+/-9.8, p<0.001), and from 5.0+/-0.8 to 2.5+/-1.3 (mean change -2.5+/-1.3, p<0.001), respectively. The percentages of responders, remitters by HDRS and patients with a CGI-I score < or =2 were 64.6%, 35.4% and 52.7%, respectively. Significant decreases in HDRS, MADRS and CGI-S scores were confirmed at week 1. The total rate of AEs was 32.3%; the most frequently reported AEs were sedation (4.3%) and constipation (4.3%). Weight was increased from 58.8+/-10.6 to 60.3+/-9.3 kg (mean change 0.7+/-1.7 kg, p=0.004). CONCLUSION: This study, as the first clinical trial of generic mirtazapine, demonstrated the efficacy and tolerability of Mirtax for MDD using a single treatment design.
Blood Pressure ; Constipation ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Drugs, Generic ; Heart Rate ; Humans ; Prospective Studies*

Laminin, an extracellular matrix glycoprotein composed of three polypeptide chains such as alpha , beta, and gamma is distributed in basement membranes of epithelium, muscle, and nervous tissues. Laminin functions as an extracellular cytoskeleton and regulates the differentiation and polarization of cells adjacent to the basement membrane. Along with type IV collagen and heparan sulfate proteoglycan, laminin forms a spike -like structure in the renal glomerular basement membrane (GBM). It has been previously demonstrated that the distribution and immune reaction of laminin are changed in response to the conditions of glomerulonephritis and that laminin plays a role in the reformation of GBM as well as the regeneration of renal glomerular cells. In the present study, the profile of expression and distribution of laminin/laminin beta1 chain were examined in different developmental stages and upon adriamycin administration. Kidney obtained from fetuses (16, 18, and 20 days old) and infants (1 and 7 days old) of Sprague -Dawley rats were either cryosectioned for immunohistochemical assays or ultrathin -sectioned for electron microscopy using immunogold staining methods. The results were as follows: 1. Intensive expression of laminin was observed in the GBM and surrounding mesenchymal tissues obtained from 16, 18, and 20 days old fetuses and in the glomerulus from one day neonates, whereas the level of staining decreased in the glomerulus from 7 days old infants. 2. Immunogold particles were observed in the comma -shaped nephron, in particular in cisternae of rough endoplasmic reticulum, vesicles and nuclear membrane of endothelial cells and mesangial cells obtained from 18 days old fetuses. 3. The immune reactions of laminin beta1 chain were trace detected in the kidney from fetuses (16, 18, and 20 days old) and weakly in tissues surrounding blood capillary and mesangial tissues from one day old neonates. 4. After 24 hours following adriamycin treatment, the reactivity of laminin was slightly enhanced in the renal glomerulus, when compared with that of untreated controls. This enhancement persisted up to 1 week of adriamycin treatment. Laminin beta1 chain was weakly detectable, while further treatment with adriamycin for another 24 hours reduced the intensity of laminin beta1 chain. Taken together, these results suggest that laminin is localized in the GBM at the high level during early fetal stages but the expression levels decrease after birth. Moreover, administration with adriamycin may result in an increase in the immune reactivities of laminin and laminin beta1 chain by renal tissue damage followed by renal regeneration.
Animals ; Basement Membrane ; Capillaries ; Collagen Type IV ; Cytoskeleton ; Doxorubicin ; Endoplasmic Reticulum, Rough ; Endothelial Cells ; Epithelium ; Extracellular Matrix ; Fetus ; Glomerular Basement Membrane ; Glomerulonephritis ; Glycoproteins ; Heparan Sulfate Proteoglycans ; Humans ; Infant ; Infant, Newborn ; Kidney* ; Laminin* ; Mesangial Cells ; Microscopy, Electron ; Nephrons ; Nuclear Envelope ; Parturition ; Rats* ; Regeneration

PURPOSE: Sildenafil citrate(Viagra(R)), a PDE-5 inhibitor in the corpus carvenosum to facilitate penile erection has improved impaired erectile responses in men and has been accepted as a primary treatment of erectile dysfunction. However, complications occurred by Viagra have increased due to its overuse and misuse. Therefore, we have performed a survey to compare physicians and general population in Busan, Korea to assess their understanding of Viagra. Methods and Materials: In 2007, printed surveys were mailed to randomly sampled candidates of 197 primary physicians and 696 individuals from general population, 327 medical students in Busan were surveyed by door-to-door visits. We assessed opinions associated with Viagra eliciting their understanding about its safety, direction, and complications. Data were analyzed using SPSS and were identified by crosstabulation analysis using Ki-square test. RESULTS: Of 1,265 eligible responses, several differences were found between the 3 groups. Compared to general population, the others were more likely to understand the efficacy, directions, and complications of Viagra. Physicians and medical students(43.1% and 39.0%) gave more preference than general population(26.1%) to using Viagra. There were differences in understanding of Viagra with changes of education level. However, it showed no significant differences about idea of illegal Viagra and combination usage with nitrates. Conclusion: The number of patients using Viagra is increasing but their understanding about Viagra is still poor. Moreover, general populations understand Viagra as 'assistant' for erection poorly. Even some medical students understand more than physicians. The ideas of complications would likely affect to negative thinking about usage for Viagra. Therefore more active and continuous educations for proper use of Viagra are suggested for medical efficacy and less complications.
Erectile Dysfunction ; Humans ; Korea ; Male ; Nitrates ; Penile Erection ; Piperazines ; Postal Service ; Purines ; Students, Medical ; Sulfones ; Thinking ; Sildenafil Citrate