No abstract available.
Radiography, Thoracic* ; Thorax*

We have studied the vasodilating effect of bolus doses of sodium nitroprusside (SNP), nitro- glycerin (NTG), and isosorbide dinitrate (ISDN) in 40 patients during cardiopulmonary bypass with a constant pump flow. Blood volume of the venous reservoir and mean arterial pressure were recorded for 10 minutes after drug administration to detect changes in venous capacitance and arteriolar resistance. SNP 500 ug decreased mean blood pressure significantly more than NTG and ISDN compared with placebo. NTG 500 ug decreased mean blood pressure transiently at 1-4 min but significantly reduced reservoir blood volume. ISDN 500 ug increased mean blood pressure after drug administration, decreased reservoir blood volume less than NTG. We could conclude that SNP was more effective arteriolar vasodilator than NTG and ISDN, but NTG and ISDN were effective as a venodilator during cardiopulmonary bypass.
Arterial Pressure ; Blood Pressure ; Blood Volume ; Cardiopulmonary Bypass* ; Glycerol ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Nitroprusside* ; Sodium* ; Vascular Access Devices

OBJECTIVE: Immunofluorescence microscopy including confocal laser scanning microscopy and electron microscopy were used to study the production of fibronectin, tenascin, and laminin in the cumulus-corona (CC) cells surrounding mature, unfertilized oocytes after ovulation in view of their presumptive importance in the coordination of the processes leading to fertilization and early embryo cleavage, including the final maturation of the ovum, the sperm-egg interaction, and the complex biochemical mechanism between the ovum and the oviduct. METHODS: Mature oocyte-cumulus complex (OCC) was cultured for 24 and 48 hour and fixed in 3.7% formaldehyde. Specimens were incubated with a mixture of primary monoclonal antibodies recognizing different epitopes of fibronectin, tenascin, and laminin, and then with a mixture of secondary antibodies containing FITC, TRITC, and Cy-5 conjugated antibodies. Observation was made by confocal laser scanning microscope equipped with epifluorescece optics. Transmission electron microscopy were used to observe the OCC at 24 and 48 hours after cultrue. RESULTS: The immunocytochemical date demonstrated that CC masses are capable of producing fibronectin and tenascin but their production is heterogeneous in the CC population. Immunoreactivity to fibronectin and tenascin was shown mostly by inner corona cells, and the intensity of immunofluorescence decreased from the central corona cells to the peripheral cumulus cells. Colocalization of fibronectin and tenascin was evident in most CC cells. Moreover, fibronectin and tenascin immunoreactive material was observed in the intracytoplasmic areas, at the plasma membrane level as well as in the extracellular matrix. Whereas, laminin immunofluorescence was found around plasma membrane and extracellular area, but a intracytoplasmic reaction was rarely observed. The distribution of laminin immunofluorescence was similar to that of fibronectin and tenascin, but in some cumulus cells, colocalization between them was not found. Ultrastructurally, cumulus cells projected numerous long, thin microvilli into the intercellular area and some micovilli penetrated into zona pellucida. The inner layer of the cumulus mass was loose arrangement of relatively uniform, small cells with widened intercellular spaces, whereas in the outer layer, cumulus cells are rather larger in size and compact arrangement by narrow, irregular spaces. A small and large linear gap junctions were easily found at cell contacts. The cytoplasm of most cells had abundant organelles typical of steroidogenesis: numerous mitochondrias, a well-developed smooth endoplasmic reticulum, electron dense lipid droplets, and bundles of microtubules and microfilaments. Rudimentary disrupted basal lamina along the cytoplasmic border was rarely seen in a few inner conora cells. CONCLUSION: Even though the functional role of these extracellular matrix proteins remains still unclear, it is reasonable to suggest that they are necessary in various steps of the reproductive process. Cumulus cells appears to be a heterogeneous and dynamic system for suitable microenviroment of fertilization. And functional differences between corona and cumulus cells during the oocyte denudation may be accounted for particular distribution of these adhesive proteins and steroidogenesis-related organelles.
Actin Cytoskeleton ; Adhesives ; Animals ; Antibodies ; Antibodies, Monoclonal ; Basement Membrane ; Cell Membrane ; Cumulus Cells ; Cytoplasm ; Embryonic Structures ; Endoplasmic Reticulum, Smooth ; Epitopes ; Extracellular Matrix ; Extracellular Matrix Proteins ; Extracellular Space ; Female ; Fertilization ; Fibronectins* ; Fluorescein-5-isothiocyanate ; Fluorescent Antibody Technique ; Formaldehyde ; Gap Junctions ; Immunohistochemistry ; Laminin* ; Microscopy, Confocal ; Microscopy, Electron* ; Microscopy, Electron, Transmission ; Microscopy, Fluorescence ; Microtubules ; Microvilli ; Mitochondria ; Oocytes ; Organelles ; Oviducts ; Ovulation ; Ovum ; Sperm-Ovum Interactions ; Tenascin* ; Zona Pellucida

PURPOSE: The purpose of this study was to identify the effects of abdominal breathing on state anxiety, stress and tocolytic dosage for pregnant women in preterm labor. METHODS: The participants were 60 pregnant women in preterm labor who were hospitalized from April to July, 2009. Thirty participants were assigned to the experimental group and 30 to the control group. None of them had any other complications except preterm labor. The modified Mason's breathing technique was used with the experimental group 3 times a day for 3 days. Data were collected using a self-report questionnaire and chart review, and analyzed with the SPSS 13.0 WIN program. RESULTS: "State anxiety of the experimental group will be lower than that of the control group" was supported. "Stress of the experimental group will be lower than that of the control group" was supported. "The Ritodrine dosage for the experimental group will be lower than that of the control group" was supported. "The Atosiban dosage for the experimental group will be lower than that of the control group" was supported. CONCLUSION: These results indicate that abdominal breathing is an effective nursing intervention for pregnant women in preterm labor.
Adult ; Anxiety/*prevention & control ; *Breathing Exercises ; Female ; Gestational Age ; Humans ; Obstetric Labor, Premature/*drug therapy ; Pregnancy ; Premature Birth ; Ritodrine/therapeutic use ; Stress, Psychological/*prevention & control ; Tocolytic Agents/*therapeutic use ; Vasotocin/analogs & derivatives/therapeutic use

OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. METHODS: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. RESULTS: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. CONCLUSION: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.
Classification ; Drug Therapy* ; Fee-for-Service Plans ; Fees and Charges ; Health Care Costs ; Hospitals, General ; Humans ; Information Systems ; Insurance ; Insurance Claim Review ; Insurance, Health ; Outpatients* ; Product Packaging ; Prospective Payment System ; Referral and Consultation

PURPOSE: The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. METHODS: This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). RESULTS: The neuropathy score was 14.3+/-7.9. The quality of life score was 64.8+/-16.4. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. CONCLUSION: Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.
Activities of Daily Living ; Cross-Sectional Studies ; Diagnosis ; Drug Therapy ; Family Characteristics ; Female ; Genital Neoplasms, Female ; Humans ; Peripheral Nervous System Diseases* ; Quality of Life* ; Surveys and Questionnaires ; Self Report

Studies on milk transfer of drugs in non-human primates (NHPs) are among the crucial components in the assessment of peri- and postnatal toxicity because of the similarity between NHPs and humans. To evaluate the milk transfer of valproic acid (VPA) in NHPs, the toxicokinetics of VPA, an antiepileptic drug, were studied in pregnant cynomolgus monkeys. VPA was administered once daily to pregnant cynomolgus monkeys at doses of 0, 30, 90, and 270 mg/kg by oral gavage from Day 100 of gestation (GD 100) to Day 31 of lactation (LD 31). Concentrations of VPA and its metabolite, 4-ene-VPA, in the maternal plasma on GD 100, GD 140, and LD 30, and concentrations of VPA and 4-ene-VPA in the offspring plasma and milk on LDs 30 and 31, respectively, were quantified using liquid chromatography tandem mass spectrometry (LC/MS/MS). After administration of a single oral dose of VPA to pregnant monkeys on GD 100, the concentrations of VPA and 4-ene-VPA were generally quantifiable in the plasma of all treatment groups up to 24 hr after administration, which showed that VPA was absorbed and that the monkeys were systemically exposed to VPA and 4-ene-VPA. After administration of multiple doses of VPA to the monkeys, VPA was detected in the pup's plasma and in milk taken on LD 30 and LD 31, respectively, which showed that VPA was transferred via milk, and the pup was exposed to VPA. Further, the concentration of VPA in the milk increased with an increase in the dose. Extremely low concentrations of 4-ene VPA were detected in the milk and in the pup plasma. In conclusion, pregnant monkeys were exposed to VPA and 4-ene-VPA after oral administration of VPA at doses of 30, 90, and 270 mg/kg/day from GD 100 to LD 31. VPA was transferred via milk, and the VPA exposure to the pup increased with an increase in the dose of VPA. The metabolite, 4-ene VPA, was present in extremely low concentrations (< 0.5 microg/ml) in the milk and in the pup plasma. In this study, we established methods to confirm milk transfer in NHPs, such as mating and diagnosis of pregnancy by examining gestational sac with ultrasonography, collection of milk and pup plasma and determination of toxicokinetics, using cynomolgus monkeys.
Administration, Oral ; Chromatography, Liquid ; Fatty Acids, Monounsaturated ; Female ; Gestational Sac ; Haplorhini ; Humans ; Lactation ; Macaca fascicularis ; Milk ; Plasma ; Pregnancy ; Primates ; Tandem Mass Spectrometry ; Valproic Acid