No abstract available.
Prenatal Diagnosis*

Neuropathic joint, which was originally described by Charcot in 1868, has been reported by many authors since that time. Charcot's joint is a feature of various conditions, such as syringmyelia, diabetes mellitus, congenital indifference to pain and leprosy, but it is mostly depended upon tertiary syphilis. In the past few decades. the occurance of this arthropathy however, seemed to decrease with the discovery of antibiotics and efficient control of syphilis in many countries. But syphilis has become popularized in recent years because of the rapid development of transportation and an offence against public deoency throughout the world. Authors experienced 3 cases of Charcots joint in Our Lady of Mercy Hospital, Catholic Medical College, two of them were tabetic, one diabetic in origin, which affected four knee joints, two ankle joints and one tarsometatarsal joint. The patients were treated conservatively without surgical intervention on the affected joints. One was lost for foIlow up after being discharged from the hospital against medical advice and the res two cases have been on follow up. This paper is auned to illustrate the importance of clinical aspects of neuropathic joints which seemed to be in the tendency of increase in recent years. in spite of development of efficient managements of the causative diseases.
Ankle Joint ; Anti-Bacterial Agents ; Arthropathy, Neurogenic ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Leprosy ; Pain Insensitivity, Congenital ; Syphilis ; Transportation

BACKGROUND: Total intravenous anesthesia (TIVA) is by definition a technique involving the induction and maintenance of the anesthetic state with intravenous drugs alone. In particular, propofol and opioid and muscle relaxants allow enhanced control of the state of anesthesia for the entire duration of the surgical procedure. We evaluated the clinical usefulness of TIVA with fixed fentanyl concentration 3 ng/ml using isoconcentration nomogram and titrated propofol for coronary artery bypass graft. METHODS: Anesthesia was induced using 1% propofol mixed with lidocaine 0.5 mg/kg and ephedrine 10 mg (150 ml/hr) until loss of consciousness in 19 patients undergoing coronary artery bypass graft. Infusion rate of propofol was adjusted in response to blood pressure and pulse rate. To achieve constant fentanyl concentration, infusion rate of fentanyl was changed timely according to isoconcentration nomogram. Infusion of propofol and fentanyl was discontinued 15 and 30 min before predictable end of surgery, respectively. Intraoperative hemodynamics, recovery profile and postoperative analgesic requirements were checked. RESULTS: Overall intraoperative hemodynamics including cardiac index and PCWP showed no significant changes compared with preinduction control value except during CPB period. Average flow rate of propofol and fentanyl was 3.4 0.2 mg/kg/hr and 2.8 0.4 g/kg/hr, respectively. Spontaneous eye opening time was 96.4 min after discontinuation of fentanyl. More than 80% (16/19) of patients did not require any analgesic during first postoperative 24hrs for pain relief. CONCLUSIONS: TIVA with propofol and fentanyl (3 ng/ml) could be a suitable and safe anesthetic technique for coronary artery bypass graft.
Anesthesia ; Anesthesia, Intravenous* ; Blood Pressure ; Coronary Artery Bypass* ; Coronary Vessels* ; Ephedrine ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Lidocaine ; Nomograms ; Propofol ; Transplants ; Unconsciousness

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

In some clinical situations such as cerebrovascular accident, pelvic bone fracture or any bed ridden states patients do not have self control of their bowel movement. Nursing care around the perianal area is not an easy job. There is no devices which substitude the work because of the chracteristics of the anatomy of the anorectum and the fecal matter made of solid and gel state component. AIM: to evaluate the possibility of passive evacuation of the fecal matter from the rectum with a newly developed silicon device. MATERIAL AND METHODS: A New Colostomy Device (NCD; US Patent No. 5,569,216) for fixing in the stoma or rectum of human body, includes an internal balloon, a ring figured external balloon surrounding the internal balloon, a connecting tube disposed under the both internal and external balloons and supply tube containing a pair of air passages and an enema fluid passages. It is designed to be inserted into the rectum and is held in place by an inflatable external balloon and drains irrigated fecal matter through a thin collapsible connecting tube which exist in the anal canal. Six mongrel dog with 20~25 kg of body weight was used for the acute experiment. Three types (1.5, 2.0, 2.5 cm in luminal diameter of the solid portion) of NCD were applied in 3 consecutive every other days. For softening of the stool, normally harder than that of human, Psyllium dextrose 30 gm was added to the daily food. Average 750 cc of tepid water was administered through the device for bowel irrigation. Anesthesia was not used in each procedures. The amount evacuated fecal matter and remained solid stool in rectum were checked. To evaluate the rectal mucosal injury anoscopic examinations were performed. RESULTS: Stool evacuation was closely correlated with the intemal diameter of the device and stool component. The device with 2.5 cm in luminal diameter passed fecal matter well enough in 5 of 6 dogs however, smaller devices did not. Accidental prolapse of NCD were noted in 4 of 6 cases with 2.5 cm sized and all of 1.5 and 2.0 sized devices eventually until last push. CONCLUSION: The NCD with 2.5 cm of internal diameter could be used in selected clinical situations.
Anal Canal ; Anesthesia ; Animals ; Body Weight ; Colostomy* ; Dogs* ; Enema ; Glucose ; Human Body ; Humans ; Nursing Care ; Pelvic Bones ; Phenobarbital ; Prolapse ; Psyllium ; Rectum ; Silicones ; Stroke ; Water

OBJECTIVE: The involvement of IGF system in hyperandrogenism and abnormal follicular development is controversial. This study is to assess whether IGF system contribute to it in the women with polycystic ovary(PCO). METHODS: Baseline serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (ADD), prolactin, thyroid stimulating hormone (TSH), free insulin-like growth factor(IGF)-I, free IGF-II, insulin-like growth factor binding protein(IGFBP)-1, and IGFBP-3 were measured in twelve healthy regularly cycling volunteers and forty-two women with PCO then, the changes of baseline serum levels were evaluated after laparoscopic ovarian electrocauterization in nine PCO patients. In addition, the expression pattern of IGF-I and IGF-II was examined in the ovary of control and PCO group. RESULTS: Baseline levels of LH, ADD, free IGF-II, and IGFBP-3 were significantly higher in PCO group. However, there were no significant differences in the levels of free IGF-I and IGFBP-1, although free IGF-I showed decreasing tendency in PCO group. And there was a significant positive correlation between the LH and free IGF-II level in the PCO(P=0.011, r2=0.3899), but not in the control. After ovarian electrocauterization, LH, T, and ADD levels decreased, and free IGF-I and IGFBP-3 level increased. While free IGF-II and IGFBP-1 level showed no significant changes. In the ovary, expression of both IGFs showed similar pattern in normal and PCO ovaries. CONCLUSIONS: The elevated IGFBP-3 level may alter the bioavailability of IGF(s) in the PCO. The change in IGF-I level and resumption of ovulation after electrocauterization, suggest a possible role of IGF system in the impairment of follicular development in the PCO.
Androstenedione ; Biological Availability ; Carrier Proteins* ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hyperandrogenism ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Luteinizing Hormone ; Ovary* ; Ovulation ; Prolactin ; Somatomedins* ; Testosterone ; Thyrotropin ; Volunteers

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Meconium* ; Pregnancy

Postischemic functional impairment of the kidney is a severe problem following living or cadeveric renal transplantation. It is well established that a substantial component of postischemic injury is caused by oxygen free radicals generated from xanthine oxidase at ischemia/reperfusion (VR) through lipid peroxidation. Glutathione is well known as a radical scavenger of oxygen free radicals. Malonyldialdehyde (MDA) is a stable end product of lipid peroxidation. The present study was undertaken to investigate whether the measurement of levels of xanthine oxidase activity, glutathione, and MDA in renal tissue could be used as indicators of renal function following I/R injury 50 male Sprague-Dawley were divided into 3 groups; control group (N=10), allopurinol-pretreatment group (Group A, N=20) and no-pretreatment group (Group B, N=20) for in-vitro and in-vivo study. Animals in in-vitro study underwent bilateral renal ischemia for 60 min after pretreatment with allopurinol in group A and saline in group B, and left nephrectomy was then performed for study of ischemic injury. After 30 min of right renal reperfusion, right nephrectomy was then performed for VR injury study. Xanthine oxidase activity, glutathione, and MDA were measured in nephrectomized kidney tissues. In-vivo renal function studies were performed in both group A and B with measurement of creatinine clearance (Ccr) at 7th day of experiments after renal ischemia for 60 min. The xanthine oxidase activity decreased significantly in group A, but increased significantly in group B. The type conversion ratio increased significantly in group B. Glutathione levels decreased significantly in group B compared to group A. MDA levels increased significantly in group B compared to group A. Ccr decreased significantly in group B compared to group A. Thus, it is suggested that the measurement of levels of xanthine oxidase activity, glutathione, and MDA in renal tissue following ischemia/reperfusion injury could be used as indicators of renal function.
Allopurinol ; Animals ; Creatinine ; Free Radicals ; Glutathione ; Humans ; Ischemia ; Kidney ; Kidney Transplantation ; Lipid Peroxidation ; Male ; Malondialdehyde ; Nephrectomy ; Oxygen ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Xanthine Oxidase

PURPOSE: In this study, behavioral styles of Dominance, Influence, Steadiness, and Conscientiousness (DISC) were examined and differences in job satisfaction and clinical competence among newly hired nurses were explored. METHODS: For this explanatory correlational research, 176 newly hired clinical nurses were recruited from three university hospitals and one general hospital located in Seoul and Gyeonggi province. Data were collected in August, 2013 though self-report questionnaires. RESULTS: The distribution of behavioral styles was 11.4%, 42%, 29% and 17.6% for Dominance, Influence, Steadiness, and Conscientiousness respectively. DISC behavioral styles were associated with sub-areas of job satisfaction such as professional position and doctor-nurse relationship. DISC behavioral styles were significantly associated with the total score for clinical competence and sub-areas of data collection, basic nursing skills, critical thinking, education and leadership, and attitudes toward professional development and practical skills. Multiple linear regression analysis showed that DISC behavioral styles predicted clinical competence (Adj. R2=.14, F=9.42, p<.001). CONCLUSION: A focus on cultivating influential and steady behavioral styles among newly hired nurses can be helpful in improving job satisfaction and clinical competence. There is a need to improve interpersonal relationships through a deeper understanding of each person's behavioral style based on the analysis of DISC behavioral styles.
Clinical Competence ; Data Collection ; Education ; Gyeonggi-do ; Hospitals, General ; Hospitals, University ; Job Satisfaction* ; Leadership ; Linear Models ; Nursing ; Surveys and Questionnaires ; Seoul ; Thinking

Normal and abnormal follicular growth and steroidogenesis depend on gonadotropins as well as intraovarian peptides, which may mediate or potentiate gonadotropin action. Inhibin also affect follicular development and steroidogenesis and may play a role in dominant follicle selection and follicular atresia. Therefore, we studied the differences of serum inhibin, gonadotropin and androgen levels in the women with only the ultrasound findings and no disorder, and polycystic ovary (PCO) with ovulatory disturbance. We prospectively analysed forty-three women with PCO. The diagnosis of PCO was based on typical appearance of the ovaries on TVS. Twelve women with regular menstrual cycle and normal ovarian morphology were selected as control. Basal levels of inhibin, luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E2), testosterone(T), androstenedione(ADD), dehydroepiandrosterone-sulfate(DS), prolactin and TSH in serum were determined. There were significant differences in basal LH levels and LH/FSH ratio between the control and the women with PCO. The basal levels of inhibin and E2 in the oligo-amenorrheic PCO (N=34) were significantly higher than those in the control. There was higher negative correlation between the inhibin and T levels in the oligo-amenorrheic PCO, but, not in the regular cycling PCO. Also, there was higher positive correlation between the LH and T levels in the oligo-amenorrheic PCO, but not in the regular cycling PCO. These data presume that the initial event of PCO is elevated pituitary LH secretion. Elevated levels of LH may down-regulate LH receptors on granulosa cells and also cause hypertrophy of the thecal layer. High level of androgen secreted by the hypertrophied thermal layer may stimulate inhibin secretion from granulosa cells and can be converted to estrogen by extraovarian tissues and could serve to augment pituitary sensitivity to GnRH with a resultant secretion of more LH follicular development and dominant follicle selection resulted in ovulatory disturbance.
Diagnosis ; Estrogens ; Female ; Follicular Atresia ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Granulosa Cells ; Humans ; Hypertrophy ; Inhibins* ; Lutein ; Menstrual Cycle ; Ovary* ; Peptides ; Prolactin ; Prospective Studies ; Receptors, LH ; Ultrasonography