Coronary atherosclerosis begins with the impairment of endothelial function of anti-thrombosis, vasorelaxation, anti-proliferation, and anti-atherosclerosis. Endothelial dysfuction is induced not only by bio-chemical factors such as hypercholesterolemia, smoking, hypertension, and diabetes mellitus, but also by bio-mechanical factors, such as disturbance of laminar flow of blood stream. In addition to these conventional risk factors, new ones emerge as important factors for atherosclerosis, which include hyperhomocysteinemia, oxidative stress, and infectious agents. The results of the several ongoing trials of antibiotics, antioxidant, and vitamins for prevention of cardiovascular diseases will elucidate implications of these new risk factors for coronary atherosclerosis. The new insight on the pathogenesis of coronary atherosclerosis will change the preventive measures against cardiovascular events. We have to pay attention not only to the conventional measures such as reducing the cholesterol level, correcting hypertension, and prescribing anti-platelet agents, but also to the new measures such as reducing the homocysteine level by folate and vitamin B, encouraging intake of antioxidant in fresh vegetables and nuts, and eradicating infectious agents by oral care and ulcer treatment.
Anti-Bacterial Agents ; Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels ; Diabetes Mellitus ; Folic Acid ; Homocysteine ; Hypercholesterolemia ; Hyperhomocysteinemia ; Hypertension ; Nuts ; Oxidative Stress ; Risk Factors ; Rivers ; Smoke ; Smoking ; Ulcer ; Vasodilation ; Vegetables ; Vitamins

Antibiotics are prescribed to prevent infection and to treat established or presumptive infections. In choosing the appropriate antibiotics, a number of factors must be considered. First, the identity of the infecting organism must be known. Second, the information about the antibiotic susceptibility of the infecting organism must be as accurate as possible. Finally, host factors must be taken into consideration. The pharmacokinetics and pharmacodynamics of antibiotics in children are different from those in adults and are important host factors. The antibiotics may be classified into several groups : the beta-lactams (i.e., penicillins, cephalosporins, carbacephems, and monobactam), glycopeptides (i.e., vancomycin), aminoglycosides, macrolides, and quinolones. This article describes the clinical application of selected antibiotics to infectious diseases with newly available agents in children. The development of new oral agents prescribed as once or twice per day achieves enhanced compliance. These include cefprozil, cefpodoxime, loracarbef, azithromycin, clarithromycin, and fluoroquinolones. Meropenem is also a newly available carbacephem approved for use in children. Antibiotics available but not approved for use in children are imipenem-ci-lastatin, aztreonam, quinolones, and several cephalosporins including "fourth"-generation such as cefipime. Recently the use of once-daily dosing of aminoglycosides has been evaluated in pediatric populations, which appears to be safe and effective, although further studise are warranted. The emergence of antibiotic-resistant bacteria has generally been correlated with the rise of specific antibiotic use in clinical practice. Although the development of resistance may be inevitable, the rate at which it develops may be diminished by the rational use of antibiotics.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Azithromycin ; Aztreonam ; Bacteria ; beta-Lactams ; Cephalosporins ; Child ; Clarithromycin ; Communicable Diseases ; Compliance ; Fluoroquinolones ; Glycopeptides ; Humans ; Macrolides ; Penicillins ; Pharmacokinetics ; Quinolones

BACKGROUND: The renin-angiotensin system (RAS) plays a crucial role in pathophysiology of congestive heart failure and ventricular remodeling after myocardial infarction (MI). There are two components, systemic and local, in RAS. There has not been a study to analyze differentially the sequential changes of systemic and local RAS after MI. The aim of this study was to analyze the sequential change of the expression of angiotensinogen mRNA, the first component of the renin-angiotensin system, in liver and non-infarcted myocardium in rats after myocardial infarction. METHOD: Female Sprague-Dawley rats (body weight 200-250 g) were subjected either to left coronary artery occlusion or to sham operation. And the rats were sacrificed at 1, 4, 18, 24 hours, 3 days, 2, 3 weeks. Hemodynamic measurement was performed and RNA was extracted from various tissues including liver and ventricle for the analysis of the expression of the angiotensinogen mRNA by northern blot analysis or RT-PCR. RESULTS: Coronary artery ligation resulted in comparable infarct sizes among rats at 3 weeks after MI and was accompanied by significant increases of LVEDP (preMI 11+/-2 vs postMI 21+/-3 mmHg, n=4). Systolic arterial pressure was reduced in animals with infarction (preMI 130+/-15 vs postMI 90+/-10 mmHgn n=4). The liver angiotensinogen mRNA levels increased at 4, 18, 24 hours after myocardial infarction and decreased at 3rd day to control values (Angiotensinogen/GAPDH;preMI 1.35+/-0.20 vs postMI 5.97+/-0.25, max 4-fold, n=3). After sham operation, the liver angiotensinogen mRNA levels increased also at 4, 18, 24 hours, but in a less degree (Angiotensinogen/GAPDH;preop. 2.15+/-1.17 vs postop. 3.41+/-1.76, max 1.5-fold, n=3). In contrast to the liver, small amounts of angiotensinogen mRNA were detectable in normal left ventricle of rat with RT-PCR. The myocardial angiotensinogen mRNA levels decreased transiently in acute phase after MI, and recovered at 3-day after MI and increased further afterwards upto 3rd month after MI. CONCLUSION: The angiotensinogen in liver was activated early during acute phase after MI and decreased toward normal as the stable state was achieved. In contrast to the circulating RAS that was activated in acute phase after MI, the local RAS in heart was activated in chronic phase after MI.
Angiotensinogen* ; Animals ; Arterial Pressure ; Blotting, Northern ; Coronary Vessels ; Female ; Gene Expression ; Heart ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Infarction ; Ligation ; Liver* ; Myocardial Infarction* ; Myocardium* ; Rats* ; Rats, Sprague-Dawley ; Renin-Angiotensin System ; RNA ; RNA, Messenger* ; Ventricular Remodeling

No abstract available.
Genetic Predisposition to Disease*

No abstract available.
Laser Therapy*

No abstract available.

Purpose This research is aimed at developing a substantive theory related to the experience of adjustmented hemodialysis patients by identifying and analyzing the nature, process, and types of adjustmentt experienced by them. For this purpose, this study takes a grounded theory approach. METHOD: Data were collected from April. 2002 through September, 2002 through in-depth interviews and close observations of eleven hemodialysis patients who have experienced adjustment. With their consent, the interviews were recorded by audio tapes and later transcribed. Observation memos were also prepared on the subjects' behavior during the interviews. Data collection continued until saturated. The data were analyzed into concepts, subcategories, and categories with the open coding process. The axial coding was done to identify the relationships of the concepts and categories. And the selective coding was done to develop a core category, which is the central phenomenon of the hemodialysis patients who experienced adjustment. RESULT: This process resulted in 88 concepts, which may be grouped into 24 subcategories and 6 core categories. The 6 categories, in fact, depict the process of changes the patients experience from the sense of crisis, self-control. And its core is self-control, which encompasses the dynamic stages from recognition, change attempts, belief solodification, and empowerment. CONCLUSION: The results of the research offer the following implications. First, research on adjustment is a formative stage in nursing, it is imperative for nursing researchers to develop them, which may be more relevant to nursing. Second, it is important to develop nursing intervention techniques that may be most effective in adjustment of hemodialysis patients and at the same time for each stage of changes taking place in adjustmented hemodialysis patients.
Clinical Coding ; Data Collection ; Humans ; Nursing ; Nursing Research ; Power (Psychology) ; Renal Dialysis*

BACKGROUND: Clostridium difficile infection (CDI) is the predominant cause of hospital-acquired diarrhea. This study evaluated the sporicidal activities of several disinfectants against C. difficile spores. METHODS: We used toxigenic C. difficile strains with different ribotypes for our study. We compared the sporicidal activities of Cavicide (Metrex Research Corporation, USA), Cidex OPA (Advanced Sterilization Products, USA), 1% Rely+On Virkon (Dupont, UK), 0.25% Surfanios (Laboratoires Anios, France), sodium hypochlorite (Yuhan Clorox, Korea), and 70% ethyl alcohol (Duksan, Korea) by using dilution-neutralization method. The sporicidal activity of the disinfecting agents was considered to be the inactivation factor (IF). The IF was calculated as the log10 colony forming unit (CFU) reduction of the viable count from the initial inoculums. Disinfectants were considered to be sporicidal if they showed an IF> or =4. RESULTS: Cavicide, 70% ethyl alcohol, Rely+On Virkon, and Surfanios showed no reduction in spore counts at all exposure time. Solutions of sodium hypochlorite diluted 1:100 (> or =400 ppm available chlorine), 1:50, and 1:20 were sporicidal after 5 min, 2 min, and 30 s, respectively. Cidex OPA showed sporicidal activity after 30 min. CONCLUSION: To prevent the transmission of CDI, at least 1,000 ppm sodium hypochlorite solution should be used to disinfect the hospital environment. Contaminated endoscopes should be disinfected with Cidex OPA for more than 30 min.
Chlorophenols ; Clostridium ; Clostridium difficile ; Colony Count, Microbial ; Diarrhea ; Disinfectants ; Endoscopes ; Ethanol ; Glutaral ; Peroxides ; Ribotyping ; Sodium Hypochlorite ; Spores ; Stem Cells ; Sterilization ; Sulfuric Acids

Blue nevi commonly occur on the skin of head, neck, and arms, and in occasional instances they have been observed in the mucosa of oral cavity, vagina, hard palate, and even breast, and in very rarity observed in the uterine cervix. We have experienced a case of blue nevi on the uterine cervix of a 45 year old famale who was operated under the diagnosis of uterine myoma. In gross findings, besides two well circumscribed uterine myomas measuring 3.5 cm and 0.6 cm in diameter in the anterior myometrium, multiple pin-point sized grayish blue pigments measuring 2-3 mm in diameter aggregated in the submucosa of the uterine cervix. Microscopically the blue nevi showed greatly elongated, slender often slightly wavy melanocytes with long, occasionally branching dendritic processes lie grouped in irregular bundles in the submucosa of the uterine endocervix. The pigments showed positive response to the Fontana-Masson stain in the cytoplasm and the extracellular area.
Female ; Humans

No abstract available.
Mycobacterium bovis*