Background: Levothyroxine is an essential drug for the treatment of hypothyroidism or related diseases. Several studies have reported an association between the effects of levothyroxine treatment and time of administration, which can be inconsistent. Objective: This study was conducted to compare the levels of thyroid-stimulating hormone or free thyroxine between morning and nighttime dosing of levothyroxine. Methods: We reviewed previously reported relevant articles and conducted a meta-analysis. Results: In total, five studies were included in this meta-analysis. Results showed that thyroid-stimulating hormone (standard difference in means [SE]=0.321; 95% confidence interval [CI], -0.016 to 0.657) and free thyroxine (SE= −1.367; 95% CI, -2.943 to 0.210) levels did not differ significantly between morning (before breakfast) and nighttime (before bedtime) administration. Conclusion This is the first meta-analysis to evaluate the effects of time of administration on levothyroxine levels in patients with hypothyroidism. Based on our results, we suggest considering patients’ lifestyles or daily routines when counselling them on the optimal time of administration for levothyroxine.

Hantavirus infection occuring during pregnancy is rarely progressing to adult respiratory distress syndrome (ARDS), which is accompanied by thrombocytopenia, leukocytosis, fever, oliguria, aggravation of bleeding, hematuria, lactacedemia. Pregnancy may have an unfavorable impact on the pathophysiologic characteristics of ARDS. The high oxygen demands of pregnancy are unable to be matched by oxygen delivery in ARDS and may predispose the patient to multiple organ failure, as well as fetal oxygen deprivation. We present the case with hantavirus pulmonary syndrome complicating pregnancy.
Fever ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Hematuria ; Hemorrhage ; Humans ; Leukocytosis ; Multiple Organ Failure ; Oliguria ; Oxygen ; Pregnancy* ; Respiratory Distress Syndrome, Adult ; Thrombocytopenia

PURPOSE: This study reviewed articles related to breast cancer, cognitive function and chemotherapy available in 4 databases. METHODS: The researcher reviewed 32 pieces of literature that were published between January 2001 and November 2011. RESULTS: Within the last decade, several studies have investigated whether adjuvant treatment of breast cancer affects cognitive function. A number of prospective studies have reported inconsistent results regarding whether chemotherapy affects cognitive function. Approximately half of the studies reported subtle cognitive decline in a wide range of domains among some breast cancer patients following chemotherapy, and others did not. CONCLUSION: Breast cancer patients receiving adjuvant chemotherapy showed the most deterioration and the most persistent decline in cognitive function. Since cognitive impairment is subtle, if evident at all, discrepant findings are due to hormonal, physiological, psychological or temporal confounding variables and differences in study design. Especially, that chemotherapy may impair memory, executive function, attention and visuospatial function in women with breast cancer.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cognition ; Confounding Factors (Epidemiology) ; Executive Function ; Female ; Humans ; Memory

Mastoparan is an amphiphilic tetradecapeptide derived from wasp venom which activates G-proteins. Several secondary effects have been attributed to this peptide, including activation of phospholipase and phosphatidylinositol kinase. The aim of the present study was to investigate the effects of mastoparan on vascular contractility. Rabbit aortic rings were cut and mounted on a force transducer to record isometric tension on a polygraph. The effects of mastoparan were then investigated on the contractile responses in the isolated rabbit aorta with or without endothelium. The results were summarized as follows; 1. Mastoparan caused biphasic response, a transient relaxation followed by a further contraction, in norepinephrine (NE)-precontracted ring with endothelium. These effects were not observed in the aorta in the absence of endothelium. 2. Mastoparan-induced transient relaxation was significantly inhibited by treatment with a N-omega-nitro-L-arginine or methylene blue. 3. When an inhibitor of phospholipase C, neomycin was added to the precontracted aortic ring with NE, the transient relaxation induced by mastoparan was inhibited, but sustained contraction was not inhibited. 4. When an inhibitor of phospholipase A2, quinacrine and inhibitor of the cyclooxygenase pathway, indomethacin, were added to a precontracted ring with NE, the transient relaxation induced by mastoparan was not inhibited, but sustained contraction was inhibited. 5. Mastoparan induced a contraction of the aorta either with or without endothelium. Indomethacin and nifedipine inhibited mastoparan-induced contraction. From the above results, we concluded that mastoparan acts on the endothelium and modifies the release of endothelium-derived relaxing factors such as nitric oxide and also endothelium-derived contracting factors such as metabolites of arachidonic acid.
Animal ; Aorta/*drug effects/physiology ; Arginine/analogs & derivatives/pharmacology ; Calcium/metabolism ; In Vitro ; Indomethacin/pharmacology ; Neomycin/pharmacology ; Nitroarginine ; Quinacrine/pharmacology ; Rabbits ; Support, Non-U.S. Gov't ; Vasoconstriction/*drug effects ; Wasp Venoms/*pharmacology

PURPOSE: This is the methodological study to develop the cognitive function scale for breast cancer patients. METHODS: Study was consisted with 1st and 2nd items developing and testify for reliability and validity of them. 94 breast cancer patients in 2 university hospitals and 1 general hospitals responded to a questionnaire that assessed cognitive function scale. Collected data were analysed using the program SPSS/PC Win 21.0. Structural validity was determined factor analysis and convergent validity. This method yielded Cronbach's α value as an internal consistency for the reliability. RESULTS: Factor analysis resulted in six factors and 24 items accounted for 76.31% of the variance. Cronbach's α of scale developed was high as a .95. CONCLUSION: The developed cognitive function scale in breast cancer patients scale has reliability and validity as linear analogue scale witch quantitatively measure the subjectivity. Over these results, providing the way on an assessment in cognitive function in effect for breast cancer patients, it is supposed to contribute the development of nursing knowledge about the cognitive function in breast cancer patients.
Breast Neoplasms* ; Breast* ; Cognition* ; Hospitals, General ; Hospitals, University ; Humans ; Methods ; Nursing ; Reproducibility of Results

Arsenic (As) is a well-known human carcinogen and its dietary exposure has been found to be the major route of entry into general population. This study was performed to assess the body levels of As and their associated factors in Korean adults by analyzing total As in urine. Urine and blood samples were collected from 580 adults aged 20 years and older, who had not been exposed to As occupationally. Demographic information was collected with the help of a standard questionnaire, including age, smoking, alcohol intake, job profiles, and diet consumed in the last 24 hrs of the study. Total As, sum of As(III), As(V), monomethylarsonic acid (MMA), dimethylarsinic acid (DMA), in urine was determined using atomic absorption spectrometer involving hydride generation method. The geometric mean concentration of total As in urine was 7.10 microg/L. Urine As was significantly higher in men (7.63 microg/L) than in women (6.75 microg/L). Age, smoking, alcohol consumption, and job profiles of study subjects did not significantly affect the concentration of As in urine. No significant relationship was observed between body mass index (BMI), Fe, and total cholesterol in serum and urinary As. Urine As level was positively correlated with seaweeds, fishes & shellfishes, and grain intake. A negative correlation between urinary As level and HDL-cholesterol in serum and meat intake was observed. Overall, these results suggest that urinary As concentration could be affected by seafood consumption. Therefore, people who frequently consume seafood and grain need to be monitored for chronic dietary As exposure.
Absorption ; Adult ; Aged ; Alcohol Drinking ; Arsenic ; Arsenicals ; Body Mass Index ; Cacodylic Acid ; Edible Grain ; Cholesterol ; Diet ; Female ; Fishes ; Humans ; Life Style ; Male ; Meat ; Occupations ; Surveys and Questionnaires ; Seafood ; Shellfish ; Smoke ; Smoking

PURPOSE: The purpose of this study was to analyze the trend of cognitive developmental interventions on patients with breast cancer who underwent chemotherapy. METHODS: The researcher searched databases and selected 17 literatures using chemotherapy, breast cancer, cognitive function and intervention as searching key words. Searched databases included Ovid, Pubmed, Proquest and Medline and data collection period was from January 2000 to May 2010. RESULTS: Interventions for patients with breast cancer have been continuously developed and frequent research topics included breast cancer, chemotherapy, quality of life, and cognitive function. In terms of study design, four research articles were pre-experimental study designs, one was case study, and the rest of studies were nonequivalent pretest-posttest control group design. Effects of intervention were examined in only 5 studies among 17. The interventions were not found to have direct effects in cognitive improvement. CONCLUSION: It is needed to figure out the mechanism of cognitive deterioration of the patients with breast cancer who underwent chemotherapy. And nursing interventions needs to be developed in order to hold up the cognitive downhill and help their cognitive rehabilitation.
Breast ; Breast Neoplasms ; Cognition ; Data Collection ; Humans ; Clinical Trial ; Quality of Life

Cytomegalovirus (CMV) pneumonia is a serious opportunistic infection in an immunocompromised host such as an AIDS patient or transplant recipient undergoing immunosuppressive therapy. Diffuse alveolar hemorrhage (DAH) is a relatively uncommon condition and it occurs most often in patients with systemic autoimmune disease. However, various types of infectious pneumonia with Mycoplsma hominis, Stenotrophomonas maltophilia and Pneumocystis jirovecii have been reported to be associated with the development of DAH. The association of CMV infection with the development of DAH has rarely been reported. We experienced a case of DAH associated CMV pneumonia and the patient was successfully treated with the use of antiviral agents and steroids.
Antiviral Agents ; Autoimmune Diseases ; Cytomegalovirus ; Cytomegalovirus Infections ; Hemorrhage ; Humans ; Immunocompromised Host ; Opportunistic Infections ; Pneumocystis jirovecii ; Pneumonia ; Stenotrophomonas maltophilia ; Steroids

PURPOSE: The purpose of this study was to describe the experiences of the process of the change in cognitive function for women treated with chemotherapy for breast cancer. METHODS: There were ten participants in total in this study. Data were gathered utilizing in-depth interviews over 3 times from September 2010 to January 2011. Data were analyzed by employing Strauss and Corbin's (1998) grounded theory methodology. RESULTS: Findings indicate that causal conditions of these results were 'side effects of chemotherapy' and 'menopausal state', including contextual conditions as, 'mental fatigue' and 'anxiety about recurrence'. The core category was identified as 'confronting with unexpected chaos'. Intervening conditions were 'support from other people', 'lack of information on cognitive impairment'. Interaction strategies were 'changing the habit of life', 'making efforts for living life' and 'seeking for medical information'. Consequences of the process were 'physical restriction', 'difficulty in social life', 'disturbed working ability' and 'psychological distress'. CONCLUSION: The results of this study show that nurses should recognize there is a notable difference between individual patient's contextual conditions and interactive strategies. Furthermore educational information and individualized intervention should be provided to improve cognitive function for women with breast cancer.
Breast ; Breast Neoplasms ; Cognition ; Female ; Humans

PURPOSE: This study analyzed recent trends of instrument usage assessing cognitive function of breast cancer patients undergoing chemotherapy. METHODS: The researcher collected 64 studies outside the country that were published between January 1996 and August 2010. RESULTS: There was no study on the instrument assessing all domains of cognitive function in breast cancer patients undergoing chemotherapy. Most instruments assessing cognitive function of breast cancer patients have been used for patients with dementia, depression, and/or organic brain damage. Also the objective neuropsychological tests such as the grooved pegboard for the psychomotor area, RCFT copy in visuospatial skill area and the WAIS-III block design have low sensitivity for measuring cognitive function in breast cancer patients, thus they are not good for applying to breast cancer patients. CONCLUSION: There is a need to develop an instrument which has good sensitivity and specificity for measuring the cognitive function of the breast cancer patients who experienced cognitive impairment after chemotherapy treatment. In addition, the developed instrument needs to be accessible and feasible in any nursing clinical setting for the purpose of accurate assessment and evaluation of the cognitive function among breast cancer patients.
Brain ; Breast ; Breast Neoplasms ; Coat Protein Complex I ; Cognition ; Dementia ; Depression ; Humans ; Neuropsychological Tests ; Sensitivity and Specificity