No abstract available.
Arrhythmias, Cardiac*

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginally administered misoprostol(PGE1) versus dinoprostone(PGE2) for labor induction in a prospective controlled trial. METHOD: One hundred eleven patients for labor induction (including preterm rupture of membranes) were randomly assigned to receive either misoprostol 50microgram or dinoprostone 3mg intravaginally. The interval of doses was 8 hours after first dose, with a potential maximum of six dose until active labor pain was achieved. RESULTS: Among 111 patients enrolled, 55 were randomized to receive misoprostol 50microgram and 56 to receive dinoprostone 3mg with every 8 hours interval intravaginally. There were no significant differences in demographic characteristics except in Bishop score(3.81+/-1.52 vs 4.38+/-1.29, P<0.05). There were no significant differences in indications for labor induction. The interval of induction to delivery was shorter in the misoprostol group(750.8+/-518.8min) than in the dinoprostone group(1264.1+/-730.7min). Delivery within 24 hours after administration occurred more often in the misoprostol group than in the dinoprostone group (86.3% vs 65.2%, P<0.05). More than two doses for completion of delivery were frequent in dinoprostone group(36.96% vs 9.8% in misoprostol group, P<0.05). Additional Oxytocin augmentation was needed more commonly in the misoprostol group(3.64%) than in the dinoprostone group(14.29%)(P<0.05), but no significant differences were noted between two groups in total oxytocin doses and indications. Tachysystole occurred more often in the misoprostol group (12.73% vs 1.79% in the dinoprostone, P<0.05) Precipitating delivery occurred more commonly in the misoprostol group(21.82% vs 7.14% in the dinoprostone group, P<0.05). No differences in the cesarean section rate, fetal heart rate abnormalities, hyperstimulation syndrome, meconium staining, fetal outcome (Apgar score at 1 and 5 minutes, birth weight), and marternal outcome (nausea and vomitting, postpartum bleeding) were noted. The cost of misoprosl is one hundredth cheaper than dinoprostone. There was no significant differences in the fetal outcome and maternal outcome. CONCLUSION: These results suggest that intravaginal misoprostol(PGE1) is a safe drug for labor induction which is more effective and cheaper compare to intravaginal dinoprostone(PGE2).
Alprostadil* ; Cesarean Section ; Dinoprostone* ; Female ; Heart Rate, Fetal ; Humans ; Labor Pain ; Meconium ; Misoprostol* ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Prospective Studies ; Rupture

No abstract available.
Apgar Score* ; Depression* ; Humans ; Psychology*

No abstract available.
Apgar Score* ; Depression* ; Humans ; Psychology*

Capasicin, a neurotoxin extracted from red peppers, has selective effects on peptide-containing C-fiber and induces the release of neuropeptides from sensory nerve endings. Mast cells and neuropeptide-containing nerve fibers occur in close proximity throughout in the airway mucosa, around blood vessls in the smooth muscle, and beneath the epithelium. Capsaicin stimuli trigger these sensory nerve fibers to release neuropeptides, which may then initiate the process of neurogenic inflammation. Neurogenic inflammation denotes the vasodilatation and vascular permeability changes that follow neuropeptide-induced mast cell antivation. The purpose of this study was to determine whether capsaincin could induce mast cell activation in vivo. For this, effects of capsaincin on the ear swelling of mouse, degranulation of skin and mesenteric mast cells, and vascular permeability of rat in vivo were measured. We found that in vivo capsaicin induced the ear swelling of mouse, degranulation of skin and mesenteric mast cells in a dose-dependent fashion. Additionally capsaicin caused to increase of vascular permeability. These results suggest that capsaicin induces inflammation through activations of mast cell.
Animals ; Capillary Permeability ; Capsaicin ; Capsicum ; Ear ; Epithelium ; Inflammation ; Mast Cells* ; Mice ; Mucous Membrane ; Muscle, Smooth ; Nerve Fibers ; Neurogenic Inflammation ; Neuropeptides ; Rats ; Sensory Receptor Cells ; Skin ; Vasodilation

BACKGROUND: Follicular dendritic cells (FDCs) play key roles during T cell-dependent humoral immune responses by allowing antigen-specific B cells to survive, proliferate, and differentiate within the FDC networks of secondary follicles, i.e., germinal centers (GC). METHODS: A novel monoclonal antibody, 3C8, was generated by immunizing with an FDC line HK, in order to understand the molecular signals involved in the FDC-B cell interactions in the microenvironment of the GC. RESULTS: The 3C8 antibody did not bind to mononuclear cells, including T cells, B cells, and monocytes. Murine L929 and human skin fibroblasts exhibited no or little reactivity to 3C8. However, 3C8 specifically recognized HK cells by flowcytometry. Furthermore, the antigen recognized by 3C8 was restricted to the GC of the human tonsil. Dendritic networks of the GC were intensely stained by 3C8, but cells out side the GC were not. CONCLUSION: Our result s suggest that the antigen 3C8 may play some unique role on FDCs during the GC reactions.
B-Lymphocytes ; Cell Communication ; Dendritic Cells, Follicular* ; Fibroblasts ; Germinal Center ; Humans ; Immunity, Humoral ; Monocytes ; Palatine Tonsil ; Skin ; T-Lymphocytes

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

The authors analyzed 38 consecutive cases with an occipital arteriovenous malformation(AVM) in regard to visual field defect. The incidence of occipital AVM was 10.4% among 367 patients with a cerebral AVM treated between 1975 and 1994 in our institute. Bleeding rate of occipital AVM in this series was 86.8%(EE cases) and it was significantly higher than that of AVM in other locations. Of 38cases, 15 patients(39.5%) had a visual field defect on admission and all of them were accompanied by intracerebral hematomas caused by the rupture of AVMs. The presence of visual field defect did not correlate with angioarchitecture in reference to pattern of nidus, feeding artery, and draining vein. Of 15 patients with visual field defect. 10 patients showed homonymous hemianopsia and five patients, homonymous quadrantanopsia. The size and location of intracerebral hematoma correlated well with hemispheric approach : 11, parietooccipital approach : 10, with six preoperative embolization and 1 postoperative gamma knife surgery. Fifteen patients underwent gamma knife surgery with five preoperative embolization. One patient underwent embolization only. The results of treatment were as follows : There were no mortality and morbidity except for visual field defect. We confirmed complete resection or obliteration of malformed vessels in 25 patients and reduction of the nidus size in eight patients. Five patients were not followed. After gamma knife surgery, two patients showed rebleeding during the follow up period. Among 23 patients who had no visual field defect before treatment, three patients showed visual field defect after treatment(one after microsurgical resection using occipital interhemispheric approach, two after preoperative embolization). In 15 patients with visual field defect before treatment, four patients showed improvement in their visual field defect after treatment(three after microsurgical resection using occipital interhemispheric approach, one after gamma knife surgery). The parietooccipital approach did not change the status of visual field in any of the ten parients. In occipital AVM, visual field defect was the most srious morbidity. Ruptured occipital AVM had a higher incidence of hemorrhage causing a visual field defect and had a higher indication of direct surgical approach than AVM of other location. In planning surgery of occipital AVM, one has to count microsurgical anatomy based on the visual pathway as well as clinical findings such as the angioarchitecture, location of intracerebral hematoma, and preopeative visual field.
Arteries ; Arteriovenous Malformations* ; Follow-Up Studies ; Hematoma ; Hemianopsia ; Hemorrhage ; Humans ; Incidence ; Mortality ; Occipital Lobe ; Rupture ; Veins ; Visual Fields* ; Visual Pathways

Purpose: This study aimed to evaluate the cost-effectiveness of treatment with retrograde intrarenal surgery (RIRS) versus repeated shock wave lithotripsy (SWL) in patients with renal calculi. Materials and Methods: The non-retreatment rates (NRRs) and their respective real-world costs for RIRS and SWL were derived through retrospective analysis of health insurance claims data from 2015 to 2017. Decision tree modeling was performed to demonstrate the cost-effectiveness of RIRS. Furthermore, sensitivity analysis was performed to examine the robustness of the results. Results: Analysis of the obtained data showed that NRRs of single SWL ranged from 46% to 56%, whereas NRRs of single RIRS ranged from 75% to 93%. Introducing RIRS early in the treatment sequence was observed to be favorable for the reduction of overall failure (overall NRR, 0.997) compared to the results of repeated SWL (overall NRR, 0.928). The implementation of decision tree modeling revealed that the cost per retreatment-avoided increased with the introduction of RIRS at an earlier time (first line, second line, third line, fourth line: 18640 USD, 10376 USD, 4294 USD, 3377 USD, respectively). Probabilistic modeling also indicated that the introduction of RIRS as the first line of treatment was least likely to be cost-effective, when compared to other options of introducing RIRS as the second, third, or fourth line of treatment. Conclusion Performing RIRS as early as possible

BACKGROUND: This study evaluated the accuracy of smoking habit from the data obtained from the medical records of lung cancer patients against the data obtained form face-to-face interview questionnaires METHODS: The smoking habits of 225 lung cancer patients were categorized into never smoked, ex-smoker and current smoker in face-to-face interview questionnaire and medical record taken at the time of admission for a diagnosis. The overall agreement between two sources was evaluated. The factors affecting the disagreement between two sources and the level of data omission of the smoking habits in medical records were analyzed suing multiple logistic regression. RESULTS: The smoking habit between two sources showed moderate overall agreement(Kappa (kappa)=0.60). The lowest agreement was observed in the ex-smokers(kappa=0.49). Multivariate analysis revealed an age of 65 or older to be a statistically significant factor associated with the increasing disagreement risk compared with those 64 or younger (OR 3.02; 95% CI 1.58-5.80). The omission rate of smoking habits in the medical records was 18.2%. Adenocarcinoma was shown to be a statistically significant factor of associated with an increasing omission rate compared with squamous cell carcinoma (OR 3.00; 95% CI 1.19-7.59). CONCLUSION: The smoking habits obtained from medical record moderately reflect their true behavior. However, the smoking habit data from medical record should be used with caution when being used in a clinical study or cohort study of lung cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cohort Studies ; Diagnosis ; Humans ; Logistic Models ; Lung Neoplasms* ; Lung* ; Medical Records* ; Multivariate Analysis ; Questionnaires* ; Smoke* ; Smoking*