To clarify the characteristics of HBV-associated renal lesions, renal biopsies obtained from 22 HBsAg seropositive patients(M:F=32:1) were studied. Other than two(age 4 and 12), all were adults(17-77 y.o.). Twelve of the patients had nephrotic syndrome(NS), 5 NS and hematuria(H), 10 proteinuria and H, one gross H, one microscopic H, and 4 normal urinalysis at the time of biopsy. Light microscopy showed minimal change lesion(MCL) in 9 cases, mesangial proliferative glomerulonephritis(MSPGN) in 6, MPGN type I in 7, MPGN type III in 6, and mebranous nephropathy(MGN) in 5 cases. There were variable immunofluorescent(IF) findings of 25 cases studied; IF staining were predominant with IgG in 10 cases, with IgA in 5 and with IgM in 2 cases. Complements tended to be more strong for C1 &/or C4 than C3. In electron microscopic(EM) studies of MCL group, rare mesangial deposits were noted(3/5). In MSPGN, aside from mesangial deposits, there were occasional subendothelia(2/4) or subepithelial(1/4) deposits. In MPGN type I, in addition to the usual EM features of MPGN, some subepithelial deposits were also observed in 5 cases. In MGN, 3 out of 4 showed subendothelial deposits. Among 7 cases stained for HBsAg all were negative with IF and 2 were positive with PAP method. It is concluded that clinico-pathological findings of HBV-associated nephropathy are variable and partly show lupus-like features, different from primary glomerulopathy.
Adult ; Male ; Female ; Humans ; Biopsy

Channels formed by the transient receptor potential (TRP) family of proteins have a variety of physiological functions. In the present study, we examined the localization of canonical transient receptor potential channels (TRPCs) in rat cerebellum. Twelve adult (4~6 month old) Sprague-Dawley rats were examined in this study. We performed immunohistochemistry using specific antibodies against TRPCs to investigate the detailed and comparative distribution of six TRPCs in rat cerebellum. There was a high density of TRPC1, TRPC3, TRPC4, TRPC5 and TRPC7, with a much lower density of TRPC6 in the rat cerebellar cortex. The somatodendritic Purkinje cell areas were intensely stained with antiTRPC3, TRPC4, TRPC5 or TRPC7 antibodies, whereas the staining intensity of TRPC6 was relatively low in the Purkinje cell bodies. In the cerebellar nuclei, the cell bodies of cerebellar output neurons showed moderate TRPC1, TRPC3, TRPC5 and TRPC7 immunoreactivities, while TRPC6 immunoreactivity was observed in the surrounding neuropil. This study showing the differential localizations of TRPC channels in the cerebellum may provide useful data for the future investigations on the structural and functional properties of TRPCs.
Adult ; Animals ; Antibodies ; Cerebellar Cortex ; Cerebellar Nuclei ; Cerebellum ; Humans ; Immunohistochemistry ; Neurons ; Neuropil ; Proteins ; Rats ; Rats, Sprague-Dawley ; Transient Receptor Potential Channels

Pigmented(melanotic) schwannoma is a very rare variant of schwannoma that characteristically has massive cytoplasmic melanin. Since it was described in 1946 by Bjorneboe, about 44 cases have been reported in the English literature. It has a relatively benign clinical course, but the cases arising in the cranial nerve and sympathetic chain show aggressive behavior with malignant potential. We herein report a typical case of pigmented schwannoma with light microscopic findings. The results of immunohistochemical and electronmicroscopic study are also presented. The patient was a 30 year-old Korean male who had a mass in his posterior neck for 10 years that recently.began to induce neurologic manifestations. The tumor, which was mainly in the extramedullary intradural space of the cervical canal extending to the extradural space and soft tissues of the neck, was relatively well defined and composed of black solid tissue. Microscopic, densely pigmented spindle cells forming fascicles, nuclear palisading, whorling and polygonal cells with vacuolated or clear cytoplasm were characteristic. Immunohistochemically, the tumor cells were positive for vimentin, S-100 protein, and HMB-45. Electron microscopic study revealed that the tumor cells have interdigitating cytoplasmic processes containing varying stages of melanosomes with a very focal basal lamina and Luse body like collagen bundles.
Male ; Humans

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poor-quality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.
Benchmarking ; Hospitals ; Humans ; *National Health Programs ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration ; Republic of Korea

Cerebral infarction is caused by decreased perfusion to the brain. In the evaluation of the infarction, CT has been widely used but MRI ans SPECT recently tend to increase in use. The purpose of this study is to compare the efficacy of MR imaging with that of 99mTc-hexamethylpropylene amine(HMPAO) single photon emission computed tomography(SPECT) in the patients with cerebral infarction in the points of (1) number of detected lesion, (2) size of the lesion, and (3) correlation with clinical neurologic deficits. Sixty-one patients with cerebral infarctions(acute: 23, subacute:30, chronic:8) were reviewed. In all patients, MRI and corresponding 99mTc-HMPAO SPECT examinations were performed within a reasonable time span. We analyzed the fiadings of (1) clinical neurologic examination, (2) MR and, (3) Tc-99m-HMPAO SPECT independently they were compared later on. The lesion of SPECT was larger than the seen on MRI in 9 of 23 acute cases, 13 of 30 subacute cases, and 3 of 8 chronic cases. The lesion on MRI was larger than that on SPECT in seven acute cases, six subacute, and only one case in chronic stage. In the remaining cases, the size of the lesion was similar to that on both SPECT and MRI. For the detection of lesion, MRI was superior to SPECT in 15 acute cases, 13 subacute cases, and four chronic cases, while SPECT was super or to MRI in four of 30 cases at subacute stage, and one of 8 cases at chronic stage. In conclusion, there was a tendency that the detection rate of the lesion was higher on MRI but the lesion was larger on SPECT. The lesions detected on both MRI and SPECT correlated well with clinical symptoms.
Brain ; Cerebral Infarction* ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Neurologic Examination ; Neurologic Manifestations ; Perfusion ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

Cardiac organoids have emerged as invaluable tools for assessing the impact of diverse substances on heart function.This report introduces guidelines for general requirements for manufacturing cardiac organoids and conducting cardiac organoid-based assays, encompassing protocols, analytical methodologies, and ethical considerations. In the quest to employ recently developed three-dimensional cardiac organoid models as substitutes for animal testing, it becomes imperative to establish robust criteria for evaluating organoid quality and conducting toxicity assessments. This guideline addresses this need, catering to regulatory requirements, and describes common standards for organoid quality and toxicity assessment methodologies, commensurate with current technological capabilities. While acknowledging the dynamic nature of technological progress and the potential for future comparative studies, this guideline serves as a foundational framework. It offers a comprehensive approach to standardized cardiac organoid testing, ensuring scientific rigor, reproducibility, and ethical integrity in investigations of cardiotoxicity, particularly through the utilization of human pluripotent stem cell-derived cardiac organoids.

No abstract available.
Animals ; Embryonic Structures* ; Mice* ; Quality Control*

The isolation arm test at upper limb for the study of muscle relaxants sensitivity of human muscle is described. In the healthy adults, succinylcholine 100ug/kg or vecuronium 5~6ug/kg combined with 20ml saline is given intravenously at various sites of injection while the circulation to the arm is occluded with upper arm pneumatic tournique. After injection of muscle relaxants, neuromuscular transmission is then studied by TOF stimulation to ulnar nerve with EMG monitor(ABM, Dates) and changes of twitch response in evoked muscle action potential amplitude from hypothenar muscle are recorded. In the results, twitch height is depressed weakly and slowly but incompletely after muscle relaxant is injected intravenously at cubital fossa, and declines further depression following recovery after the release of upper arm tourniquet occiuded systemic circulation(two stage response). There are not any changes of twitch response while muscle relaxants are given intravenously between upper arm and forearm pneumatic tourniquet. But twitch height is depressed rapidely and completely after muscle relaxants are given intravenously at doris hand under the upper arm or forearm pneumatic tourniquet. Conclusively, twitch response under the isolation arm test is influenced from the site of injection, and in order to obtain the correct assessment of neuromuscular blockade, muscle relaxants will be given intravenously at dorsi hand with forearm pneumatic tourniquet.
Action Potentials ; Adult ; Arm* ; Depression ; Forearm ; Hand ; Humans ; Neuromuscular Blockade ; Succinylcholine ; Tourniquets ; Ulnar Nerve ; Upper Extremity ; Vecuronium Bromide

BACKGROUND: During ophthalmologic surgery, a variety of anesthetic induction techniques are used in an attempt to prevent the rise of intraocular pressure (IOP). This study compared the effects of etomidate, a new intravenous anesthetic agent, on the changes in IOP with those of thiopental sodium and propofol. METHODS: Forty-five patients were randomly allocated and divided into three groups to be injected intravenously with etomidate 0.2-0.3 mg/kg (E-group, n = 15), propofol 2-3 mg/kg (P-group, n = 15) or thiopental sodium 4-5 mg/kg (T-group, n = 15). Systolic arterial pressure (SAP), heart rate (HR) and intraocular pressure (IOP) were measured at 1, 2 and 3 minutes after the administration of the induction agents. During the induction of anesthesia, the incidence of IV injection pain, myoclonus, hiccup and a decrease in SAP of more than 30% were investigated. RESULTS: At 1, 2 and 3 min following the induction of anesthesia, the SAP in the P-Group decreased significantly more than that in the other two groups (P < 0.05). After the induction, heart rate in the T-Group increased significantly more than that in the other two groups (P < 0.05). The three intravenous agents induced a significant decrease in IOP after an injection (P < 0.05). Comparing the three groups, the IOP in the E- and P-Group decreased significantly more than that in the T-Group (P < 0.05). CONCLUSIONS: Etomidate may be used as a choice of intravenous induction agent to reduce intraocular pressure in ophthalmologic operations especially in an emergency situation, geriatric and hypovolemic patients.
Anesthesia* ; Arterial Pressure ; Emergencies ; Etomidate* ; Heart Rate ; Hiccup ; Humans ; Hypovolemia ; Incidence ; Intraocular Pressure* ; Myoclonus ; Propofol* ; Sensitivity Training Groups ; Thiopental*

PURPOSE: The purpose of this study was to analyze papers published in the Journal of Korean Academy of Child Health Nursing (JKACHN) to identify the current state of child health nursing research and recommend directions for future research. METHODS: Using analysis criteria developed by the researchers, 233 papers published in JKACHN between 2005 and 2009 were reviewed. RESULTS: Both quantity and quality of these papers showed significant improvement compared to before 2005. The number of published papers, the proportion of intervention studies, and studies that involved children directly as participants had increased. However, published papers still leave much to be desired. Quantitative studies were dominant (91.4%) and many of these studies were survey designs (65.7%). Children, especially young children were still less likely to be direct participants. All experimental studies were quasi or pre-experimental studies. There were few qualitative research studies. CONCLUSION: Findings of this study indicate that strengthening peer review according to review guidelines will improve the quality of published papers and promote JKACHN as an international journal. Instead of proxy accounts from parents or nurses, research involving direct accounts by children is needed. Child-friendly data collection methods need to be developed and used by child health nurse researchers.
Child ; Data Collection ; Humans ; Clinical Trial ; Nursing Research ; Parents ; Pediatric Nursing ; Peer Review ; Proxy ; Qualitative Research ; Child Health