No effective therapy has yet developed for liver fibrosis/cirrhosis by directly inhibiting the accumulation of extracellular matrix. This study was undertaken to determine the effect of tetrandrine in rat model of liver fibrosis induced by carborn tetrachloride (CCl4) administration intraorally. Tetrandrine, a calcium channel blocker, is anti-inflammatory constituent of the families Menispermaceae and Ranunculaceae, which have been used as folk remedies in China. Repeated administration of CCl4 for 14 weeks to rats induced liver fibrosis with steatosis. Rats were killed after 4, 8 or 14 weeks of treatment with CCl4, CCl4 tetrandrine (30 mg/kg) or CCl4 tetrandrine (50 mg/kg). The histopathological findings of liver were observed semi-quantitatively by light microscopy and volume percentage of the collagen deposition was determined by image analyzer. Tetrandrine inhibited collagen deposition induced by CCl4 administration, as shown by less severe steatosis and fibrosis and significantly decreased volume percentage of collagen fibers in CCl4 tetrandrine treated animals compared with CCl4 only group. Thus, the administration of tetrandrine holds great promise for treating subjects with liver fibrosis/cirrhosis as a result of chronic hepatic injury.
Animals ; Calcium Channels ; Carbon Tetrachloride ; China ; Collagen ; Extracellular Matrix* ; Fibrosis* ; Humans ; Liver ; Liver Cirrhosis ; Medicine, Traditional ; Menispermaceae ; Microscopy ; Models, Animal ; Ranunculaceae ; Rats*

Purpose: : This study aimed to examine the effects of the awareness of patient safety culture, emotional labor, and job stress on patient safety nursing activities by comprehensive nursing care medical service ward nurses. Methods: : The participants were 112 nurses from the comprehensive nursing care service wards from six hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using SPSS version 20.0. Results: : The factors that significantly influenced patient safety nursing activities in the comprehensive nursing care medical service ward nurses included job stress (β=-0.18, p<.032) and awareness of patient safety culture (β=0.54, p<.001). The explanatory power of these factors was 31.0% (F=13.43, p<.001). Conclusion : This study showed that the factors that influenced patient safety management activities of comprehensive nursing care medical service ward nurses included job stress and awareness of patient safety culture.

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Female ; Hemangioma ; Humans ; Incidence ; Male ; Melanoma ; Neck ; Nevus, Pigmented ; Pathology, Surgical ; Seoul ; Skin*

No abstract available.
Child* ; Humans

No abstract available.
Anemia, Hypoplastic, Congenital*

Purpose: To determine associations of illness symptoms, perception of illness, coping with quality of life (QOL) of thyroid cancer patients and identify factors affecting their QOL. Methods: A cross-sectional study was performed using a self-administered questionnaire for 111 thyroid cancer patients after thyroidectomy. They were recruited from the outpatient clinic of one university hospital.Data collection was conducted from August 2018 to November 2018. Results: The QOL was significantly associated with interpersonal coping (β= 0.31, p< .001), monthly household income (β= 0.30, p< .001), illness symptoms (β= -0.22, p= .017), perception of illness (β= -0.20, p= .031), and education (β= 0.18, p= .037) in stepwise multiple regression. These factors explained 33.1% of QOL of thyroid cancer patients. Conclusion Interpersonal coping is a major contributing factor to QOL. Therefore, thyroid cancer patients need good interpersonal coping for better quality of life.

PURPOSE: There are few reports about the natural history of patients with pseudoprecocious puberty due to autonomous ovarian cyst. We reviewed the clinical course of 7 patients who had autonomous ovarian cysts and signs of precocious puberty. METHODS: We retrospectively evaluated 7 children, aged 2.8 to 7.9 years, who were diagnosed with pseudoprecocious puberty due to autonomous ovarian cysts from November 2005 to May 2011. The follow-up durations ranged from 0.5 to 6.3 years. RESULTS: Four out of 7 patients showed elevated serum estrogen levels and all revealed prepubertal response of gonadotropin to GnRH stimulation at diagnosis. The size of the cysts was from 1.7 to 4.6 cm on pelvic ultrasound examination. After 1 to 3 months, the ovarian cysts disappeared in all patients. Three of the girls developed relapsing signs of precocious puberty (vaginal bleeding and breast budding). Two of them showed an increase in growth velocity and bone age due to recurrent ovarian cysts, and one of them was converted to true precocious puberty. CONCLUSION: In our cases, all patients with autonomous ovarian cysts resolved spontaneously. However, some showed frequent recurrence of ovarian cysts, and needed a longer follow up because of the possibility of conversion to true precocious puberty and signs of McCune-Albright syndrome.
Aged ; Breast ; Child ; Estrogens ; Female ; Fibrous Dysplasia, Polyostotic ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Natural History ; Ovarian Cysts ; Puberty ; Puberty, Precocious ; Recurrence ; Retrospective Studies

BACKGROUND: The testes are one of the most common extramedullary sites of relapse in boys with acute lymphoblastic leukemia(ALL). The reported incidence of isolated testicular relapse varies from 3 to 40%. If these patients are treated exclusively with testicular irradialion, a systemic relapse occurs within a few months. Recently, the use of intensive chemotherapy and testicular irradiation improved the survival rate for boys with testicular leukemia. So, we performed this study to identify clinical manifestations, disease free survival and prognostic factors of testicular leukemia in children. METHODS: We reviewed 33 patients of testicular leukemia among total 410 boys with ALL diagnosed at the Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1970 to Aug. 1996. Testicular leukemia was confirmed by testicular biopsy in all 33 patients. These patients were treated with combined local testicular irradiation(2,400~2,500 cGy/8~12fractions) and systemic chemotherapy. Two patients, in whom testicular relapse was diagnosed before 1979, unilateral orchiectomy of the involved site and testicular irradiation of the opposite site were performed. Probability estimates of disease free survival (DFS) were calculated by the method of Kaplan and Meier, and the relationship of prognostic factors to DFS was compared using the chi-square test in survival analysis. RESULTS: In 410 boys with ALL, testicular leukemia occurred in 33 patients(8%). Of 33 patients, 6 patients presented with testicular involvement at initial diagnosis, 16 patients had testicular relapse while still receiving chemotherapy and 11 patients had testicular relapse 3 to 57 months(median : 15 months) after cessation of chemotherapy. The median age of 33 patients was 7.4 yrs(9 months~18 yrs) and median WBC count 7,600/ L(2,700~270,000/L). All patients presented with painless testicular enlargement and testicular leukemia was confirmed by testicular biopsy. Among 33 patients, 2 had prior CNS relapse and 11 had concomitant bone marrow and/or CNS relapse. Twenty nine patients were treated with combined local testicular irradiation and systemic chemotherapy. Eleven had second relapse(6 bone marrow, 3 CNS, 2 opposite testis). Seventeen have been followed until now: 6 patients on chemotherapy and 11 patients(37.9%) in complete remission for 48.5+/-22.3 months(19~86 months). The 3 year DFS for 29 patients was 55.3%+/-10.1%. The following prognostic factors showed no significant association with DFS in testicular relapse : age and WBC count at initial diagnosis, age at testicular relapse, and concomitant relapse. Whether testicular relapse occurred on initial therapy or off initial therapy has prognostic value in predicting DFS. The 3 year DFS for boys with testicular relapse on and off initial therapy were 40.0%+/-12.9% and 78.8%+/-13.4%, respectively(P: 0.046). CONCLUSION: With the use of chemotherapy and testicular irradiation, prolonged second re mission can be achieved in many patients with testicular leukemia. The patients with testicular relapse off initial therapy fared significantly better than patients on therapy. So, to improve the DFS for boys with testicular leukemia, a better understanding of its biology and prognostic factors is needed.
Biology ; Biopsy ; Bone Marrow ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Humans ; Incidence ; Leukemia ; Missions and Missionaries ; Orchiectomy ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Seoul ; Survival Rate ; Testis