No abstract available in English.
Methods ; Reference Values

The anesthetic management of a patient with pheochromoctoma in pregnancy is presented. Preoperative phenoxybenzamine therapy and careful intraoperative monitoring preduced successful cesarean section and tumor reseetion in this patient. Problems that occurred during mamagement of this patient are hypoxemia(R/0 pulmonary edema) and cardiovascular flucctuation according to the operative procedure. Hypoxemia oceurred possibly due to large amount of crystalloid infusion in a short time and was solved with applying positive end expiratory pressure and using diuretics. Blood pressure was controlled effectively with sodium nitroprusside or phenylephrine infusion according to the operative procedure. Preoperative pregnancy induced liver disease in this patient was recovered after delivery.
Anesthesia, General ; Anoxia ; Blood Pressure ; Cesarean Section ; Diuretics ; Female ; Humans ; Liver Diseases ; Monitoring, Intraoperative ; Nitroprusside ; Phenoxybenzamine ; Phenylephrine ; Pheochromocytoma* ; Positive-Pressure Respiration ; Pregnancy* ; Surgical Procedures, Operative

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

PURPOSE: To correlate the findings of perfusion-weighted imaging (PWI) with clinical outcomes in patients with acute lacunar infarction. MATERIALS AND METHODS: Eleven patients (7 males and 4 females) with acute lacunar infarction who were examined within 50 (mean, 29) hours of the onset of symptoms underwent conventional MRI, diffusion-weighted imaging (DWI) and PWI. Gadolinium (0.2 mmol/kg) was injected at a rate of 2 ml/sec, and PWI was performed using a gradient-echo EPI pulse sequence and the following parameters: TR/TE, 2000/60; flip angle, 90 degree; matrix size, 128X128. Relative cerebral blood volume (rCBV) maps were derived from gadolinium bolus perfusion-weighted images where rCBV ratios between infarcted areas were detected by DWI, and contralateral control areas were obtained. In each case, the resulting rCBV ratio at a lesion site was compared with the clinical outcome determined on the basis of the difference between National Institute Health Stroke Scale (NIHSS) scores at admission and discharge. RESULTS: With the aid of the time-intensity curve obtained at PWI, the rCBV maps revealed a hypoperfused area in 10 of 11 patients, and there was positive correlation (r=0.81) with clinical outcome. CONCLUSION: Although PWI has a lower detection rate than DWI, it may be a useful modality for helping determine prognosis in cases of acute lacunar infarction.
Blood Volume ; Diagnosis* ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Male ; Perfusion* ; Prognosis ; Stroke ; Stroke, Lacunar*

Demyelinating syndrome can rarely occur in Sjogren's syndrome or rheumatoid arthritis. We describe a patient of Sjogren's syndrome with multiple sclerosis-like features whose rheumatoid arthritis has been managed for 3 years. The patient presented paraparesis and urinary retention, and improved with high-dose corticosteroid therapy.
Arthritis, Rheumatoid* ; Humans ; Multiple Sclerosis* ; Paraparesis ; Sjogren's Syndrome* ; Urinary Retention

Understanding the definition of treatment response, remission and recovery is very critical in terms of investigating the course of schizophrenia and planning treatment strategies accordingly. In this article, we reviewed various definitions and criteria used in previous studies. Based on this, several limitations and new proposals are discussed. Clear establishment of the criteria for treatment response, remission and recovery for schizophrenia would help clinicians to make a time-appropriate decision for medication plan and to set up the long-term treatment goal in people with schizophrenia.
Schizophrenia*

PURPOSE: The traditional nursing roles have become increasingly blurred. Nurses are now working in different ways and at higher levels of practice that enable nurses to adapt their roles and take on new responsibilities. The advanced role of nurses requires a different kind of master-level prepared education. METHOD AND RESULT: This article describes an curriculum development process in preparing registered nurses for their advanced nurese' roles in the area of acute adult health nursing, geriatric nursing, pediatric nursing, neonatal intensive care nursing and oncology nursing. Several important issues to be solved regarding introduction of APN were also discussed. CONCLUSION: The curriculum that was proposed in the study will equip nurses to meet the challenges of future healthcare provision and will be a model to other areas of nursing practice and curriculum development.
Adult ; Atrial Natriuretic Factor ; Critical Care Nursing ; Curriculum* ; Delivery of Health Care ; Education ; Geriatric Nursing ; Humans ; Infant, Newborn ; Neonatal Nursing ; Nurse Practitioners* ; Nursing ; Oncology Nursing ; Pediatric Nursing

Oxidative stress-induced neurodegeneration is one of several etiologies underlying neurodegenerative disease. In the present study, we investigated the functional role of histone methyltransferase G9a in oxidative stress-induced degeneration in human SH-SY5Y neuroblastoma cells. Cell viability significantly decreased on H2O2treatment; however, treatment with the G9a inhibitor BIX01294 partially attenuated this effect. The expression of neuron-specific genes also decreased in H2O2 -treated cells; however, it recovered on G9a inhibition. H2O2 -treated cells showed high levels of H3K9me2 (histone H3 demethylated at the lysine 9 residue), which is produced by G9a activation; BIX01294 treatment reduced aberrant activation of G9a.H3K9me2 occupancy of the RE-1 site in neuron-specific genes was significantly increased in H2O2 -treated cells, whereas it was decreased in BIX01294-treated cells. The differentiation of H2O2 -treated cells also recovered on G9a inhibition by BIX01294. Consistent results were observed when used another G9a inhibitor UCN0321. These results demonstrate that oxidative stress induces aberrant activation of G9a, which disturbs the expression of neuron-specific genes and progressively mediates neuronal cell death. Moreover, a G9a inhibitor can lessen aberrant G9a activity and prevent neuronal damage. G9a inhibition may therefore contribute to the prevention of oxidative stress-induced neurodegeneration.

Oxidative stress-induced neurodegeneration is one of several etiologies underlying neurodegenerative disease. In the present study, we investigated the functional role of histone methyltransferase G9a in oxidative stress-induced degeneration in human SH-SY5Y neuroblastoma cells. Cell viability significantly decreased on H2O2treatment; however, treatment with the G9a inhibitor BIX01294 partially attenuated this effect. The expression of neuron-specific genes also decreased in H2O2 -treated cells; however, it recovered on G9a inhibition. H2O2 -treated cells showed high levels of H3K9me2 (histone H3 demethylated at the lysine 9 residue), which is produced by G9a activation; BIX01294 treatment reduced aberrant activation of G9a.H3K9me2 occupancy of the RE-1 site in neuron-specific genes was significantly increased in H2O2 -treated cells, whereas it was decreased in BIX01294-treated cells. The differentiation of H2O2 -treated cells also recovered on G9a inhibition by BIX01294. Consistent results were observed when used another G9a inhibitor UCN0321. These results demonstrate that oxidative stress induces aberrant activation of G9a, which disturbs the expression of neuron-specific genes and progressively mediates neuronal cell death. Moreover, a G9a inhibitor can lessen aberrant G9a activity and prevent neuronal damage. G9a inhibition may therefore contribute to the prevention of oxidative stress-induced neurodegeneration.

BACKGROUND/AIMS: Endoscopic grading of the gastroesophageal flap valve (GEFV) was suggested to be a good predictor of the gastroesophageal reflux status. The aim of this study was to examine the association between the GEFV and gastroesophageal reflux. METHODS: A total of 599 patients (245 men and 354 women; mean age 51.0 +/- 0.5 years) who underwent endoscopy, esophageal manometry, and ambulatory pH monitoring were included. GEFV was graded I through to IV using Hill's classification. The GEFV was classified into main 2 groups: the normal GEFV (grade I and II) and the abnormal GEFV groups (grade III and IV). The findings of endoscopy, esophageal manometry, and ambulatory pH monitoring were compared. RESULTS: An increased GEFV grade was significantly associated with reflux esophagitis and Barrett's epithelium (p < 0.001). The LES pressure was significantly lower in the abnormal GEFV group (p < 0.001). All variables showing gastroesophageal reflux in the probe were significantly higher in the abnormal GEFV group (p < 0.001). The frequency of gastroesophageal reflux disease (GERD) was higher in the abnormal GEFV group (p < 0.001). CONSLUSIONS: There is an association between the altered geometry of the GEFV and the presence of GERD. The endoscopic grading of the GEFV is easy and provides useful information on the gastroesophageal reflux status.
Classification ; Endoscopy ; Epithelium ; Esophagitis, Peptic ; Female ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Male ; Manometry