No abstract available.
Candida* ; Esophagitis* ; HIV Infections* ; HIV* ; Humans

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.
Ascitic Fluid ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; Interleukin-10 ; Interleukin-5 ; Interleukin-6 ; Menstruation Disturbances ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

Few studies have assessed the neural mechanisms of the effects of emotion on cognition in generalized anxiety disorder (GAD) patients. In this functional MRI (fMRI), we investigated the effects of emotional interference on working memory (WM) maintenance in GAD patients. Fifteen patients with GAD participated in this study. Event-related fMRI data were obtained while the participants performed a WM task (face recognition) with neutral and anxiety-provoking distracters. The GAD patients showed impaired performance in WM task during emotional distracters and showed greater activation on brain regions such as DLPFC, VLPFC, amygdala, hippocampus which are responsible for the active maintenance of goal relevant information in WM and emotional processing. Although our results are not conclusive, our finding cautiously suggests the cognitive-affective interaction in GAD patients which shown interfering effect of emotional distracters on WM maintenance.
Amygdala ; Anxiety Disorders* ; Anxiety* ; Brain* ; Cognition ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Memory, Short-Term*

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

PURPOSE: This study was conducted to examine the effects of a multicultural course on nursing students' multicultural acceptability and competency. METHODS: The research design for this study was a non-equivalent control group, non-synchronized pre- and post-test. The experimental group (n=28) took 13 weeks of the multicultural course, while the control group (n=28) received only regular classes over the same period. Pre- and post-tests were done to identify the effects of the program. The data were collected using self-administered questionnaires and analyzed using the PASW 18.0 program. RESULTS: All indices of multicultural acceptability and competency in the experimental group were significantly higher than that of control group after the program, except for two: universality (a measure of multicultural acceptability) and multicultural awareness (a measure of multicultural competency). CONCLUSION: These results suggest that the multicultural course was effective in elevating the level of multicultural acceptability and competency among nursing students.
Cultural Competency ; Humans ; Nursing* ; Research Design ; Students, Nursing*

OBJECTIVE: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks' of gestation by ultrasonographic examination of cervical changes. MATERIAL AND METHODS: This prospective study included 110 singleton low risk pregnancies between 37(+0) and 37(+6) weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. RESULTS: Mean cervical length of pregnant women at 38 weeks' of gestation was 25.8 (+/-10.0) mm and mean cervical gland thickness was 4.3 (+/-1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. CONCLUSION: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks' of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Labor Onset ; Parturition* ; Pregnancy* ; Pregnant Women ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity

Choledochal cyst is a cystic or fusiform dilatation of the extra- or intrahepatic bile duct that has rarely been reported in prenatal cases. Here we report a fetus with choledochal cyst diagnosed prenatally by three-dimensional (3-D) ultrasonography at 22 weeks of gestation. We demonstrated an image of choledochal cyst by using a new ultrasound technique, a 3-D multislice view. After close intrauterine followup, surgery was successfully performed and postoperative course was uneventful.
Anastomosis, Roux-en-Y ; Cholangiography/methods ; Choledochal Cyst/*diagnosis/*ultrasonography ; Female ; Fetal Diseases/*diagnosis/*ultrasonography ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Infant ; Male ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Treatment Outcome ; Ultrasonography, Prenatal/*methods

BACKGROUND: Apoptosis plays a crucial role in carcinogenesis, as well as in development and tissue homeostasis. Terminal deoxyribonucleotidyl transferase mediated neck end labelling (TUNEL) and in situ nick end labelling (ISEL) have been used to investigate the apoptosis in tissues. Since the introduction of the M30 monoclonal antibody to overcome drawbacks of TUNEL and ISEL, the apoptosis in various tumors, with the exception of pulmonary carcinomas, has been studied. In this study, attempts were made to examine the correlation of apoptosis in non-small cell carcinomas, using both M30 and the expression of p53 protein, with the clinicopathological factors. MATERIAL AND METHOD: Forty five patients with surgically resected non-small cell carcinomas were included. Immunohistochemical staining with M30 and p53 monoclonal antibody were performed, and their expressions compared with the clinicopathological features. The overall survival time and recurrence-free survival time were calculated, and the factors influencing the survival time analyzed using a univariate analysis. The effects of the expression stati of M30 and p53 on the risks of cancer related to both death and recurrence were evaluated using a multivariate analysis. RESULT: The p53 positive group had many more M30 positive cells than the p53 negative group (p53 positive group; 61.7+/-26.8 cells vs. p53 negative group; 45.6+/-29.6 cells, p=0.005) and significantly more p53 positive patients showing at least 10 positive cells (apoptotic index, AI > or =1) on M30 staining (p53 positive group; 52.4% [11/21] vs. p53 negative group 16.7% [4/24], p=0.025). In the univariate analysis, the survival times in relation to smoking (pack-year), performance status (PS) and AI showed significant differences. The multivariate analysis demonstrated the relative risk (R.R) of cancer death increased almost 7.5-fold (R.R 7.482; 95% CI 1.886~29.678; p=0.004) and the risk of recurrence almost 3.8-fold (R.R 3.795; 95% CI; 1.184~12.158; p=0.025) in the high AI (> or =1) compared to the low AI (<1) group. There was no prognostic effect of p53 expression on the survival time or risk of cancer death and recurrence. CONCLUSION: In non-small cell lung carcinomas, M30 immunohistochemistry was an excellent method for analyzing apoptosis; the high apoptotic index could be an adverse prognostic predictive factor.
Apoptosis* ; Carcinogenesis ; Cell Death ; DNA Nucleotidylexotransferase ; Homeostasis ; Humans ; Immunohistochemistry ; In Situ Nick-End Labeling ; Lung Neoplasms ; Lung* ; Multivariate Analysis ; Neck ; Recurrence ; Smoke ; Smoking

PURPOSE: Recently, laparoscopy assisted gastrectomy has taken its place as one of the main strategies for managing early gastric cancer (EGC). We conducted this study to evaluate its value from the point of view of initial experience. METHODS: Between June 2007 and May 2008, 63 patients who underwent laparoscopy assisted distal gastrectomy (LADG, n=43) or open distal gastrectomy (ODG, n=20) for EGC by a single surgeon, enrolled in this retrospective, non-randomized study. The operative procedure was decided on through patients' preferences. We compared several clicopathological factors and short-term postoperative outcomes between the two groups. RESULTS: There were no significant differences in the patients' demography and pathologic results between the two groups. The operation time was more shorter (167+/-23.2 vs. 268+/-68.6 mins, P<0.0001) in the ODG group, but the time to first flatus (2.8+/-0.6 vs. 3.1+/-0.4 days, P=0.033), the time to first diet (3.0+/-0.3 vs. 3.6+/-0.6 days, P<0.0001), and the duration of hospital stay (9.1+/-1.2 vs. 11.6+/-3.1 days, P<0.0001) were significantly shorter in the LADG group. Although there were no significant differences in postoperative morbidity and mortality between the two groups, one patient died of postoperative myocardiac infarction in the LADG group (P=0.6854). Comparison between before and after learning curve; there were statistically significant differences in the number of retrieved lymph nodes (31.2+/-13.7 vs. 42.2+/-13.4, P=0.0185) and the time of operation (295+/-63.8 vs. 208+/-30.5 mins, P<0.0001). CONCLUSION: Although our results represent initial experiences, we could find some advantages in LADG compared with ODG. We suggest that application of more restrictive indication is required at an earlier time on the learning curve.
Demography ; Diet ; Flatulence ; Gastrectomy ; Humans ; Hypogonadism ; Infarction ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Lymph Nodes ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Stomach Neoplasms ; Surgical Procedures, Operative

PURPOSE: To compare the clinical outcomes between refractive-type multifocal intraocular lenses (IOL) (Lentis Mplus(R) LS 313, Oculentis GmbH., Berlin, Germany) and diffractive-type multifocal IOL (Acrysof Restor(R); SN6AD1, Alcon Lab., Fort Worth, TX, USA) with same near added. METHODS: We evaluated 30 eyes implanted with Lentis Mplus(R) IOL and 33 eyes implanted with Acrysof Restor(R) IOL after phacoemulsification. The distant, intermediate, and near uncorrected visual acuities of the 2 groups were evaluated at 2 weeks and 1, 3, and 6 months postoperatively. Optical quality obtained using the Optical Quality Analysis System II (OQAS II(R), Visiometrics, Castelldefels, Barcelona, Spain), higher-order aberrations (HOAs), and patient satisfaction questionnaire of the 2 groups were evaluated at 3 months postoperatively. RESULTS: The visual acuity of intermediate 100 cm was statistically better in the Lentis Mplus(R) group (p < 0.05). There were no significant differences between the 2 groups with distant, intermediate 63 cm, and near vision. At the 3-month postoperative follow-up, objective scatter index, modulation transfer function (MTF) cutoff value, and pseudo-accommodation range measured by OQAS II(R) showed no differences between the 2 groups, but Strhel ratio was higher in the Acrysof Restor(R) group. HOAs of 5 mm and 6 mm increased significantly in the Lentis Mplus(R) group. No significant differences were found in the patient satisfaction questionnaire. CONCLUSIONS: Both refractive and diffractive-type multifocal IOL implantation in patients with cataracts and presbyopia offered good and comparable visual acuity at distance and near. However, the Lentis Mplus(R) IOL provided better intermediate vision than the Acrysof Restor(R) IOL.
Berlin ; Cataract ; Follow-Up Studies ; Humans ; Lenses, Intraocular* ; Patient Satisfaction ; Phacoemulsification ; Presbyopia ; Surveys and Questionnaires ; Visual Acuity