The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.
Abortion, Spontaneous ; Adult ; Aged* ; Cough ; Education ; Female ; Humans ; Incidence ; Menopause ; Middle Aged ; Nursing ; Pregnancy ; Prevalence ; Psychology ; Research Design ; Sneezing ; Urinary Incontinence* ; Urination

Hemolytic uremic syndrome is characterized by a triad of clinical findings including microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The precise etiology and pathogenesis of hemolytic uremic syndrome are not established by now. According to clinical reports, hemolytic uremic syndrome is associated with infection(bacteria, virus), connective tissue disease, malignancy, drug and pregnancy. Recently, many investigators have reported that cyclosporine induces hemolytic uremic syndrome. Cyclosporine is one of the immunosuppressants that are essential for kidney transplantation. We experienced one case of hemolytic uremic syndrome that developed after kidney transplantation receiving cyclosporine. A 43-yr-old woman with end-stage renal failure received kidney transplantation from her daughter. After operation, she received cyclosporine for immunosuppression and thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure were developed. She was diagnosed as cyclosporine induced hemolytic uremic syndrome and plasma exchange was started with fresh frozen plasma. The plasma exchange was done 16 times and the clinical symptoms were improved. We present this case with review of literatures.
Acute Kidney Injury ; Anemia, Hemolytic ; Connective Tissue Diseases ; Cyclosporine* ; Female ; Hemolytic-Uremic Syndrome* ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Nuclear Family ; Plasma Exchange* ; Plasma* ; Pregnancy ; Research Personnel ; Thrombocytopenia

BACKGROUND: Free fatty acids are well known as an energy source. However, theoretically it could be destructive through oxygen free radical chain reactions unless they are bound to albumin in blood. Recently, the toxicity of oxidative agents in several diseases, and additionally the behavior of antioxidants including albumin against this have been suggested. Therefore, we investigated the relationship between free fatty acid/albumin molar ratio and erythrocyte injury in this study. METHODS: Free fatty acid and albumin were analysed in thirty-eight hypoalbuminemia patients and fifty-six healthy controls. To measure the erythrocyte injury, hemoglobin, absolute and relative reticulocyte counts, and lactate dehydrogenase (LD) were also examined. In addition, glutathione peroxidase (GPX) and superoxide dismutase (SOD) were determined in both fifteen patients and fifteen controls, respectively. RESULTS: The albumin levels in study group (3.06+/-0.28 g/dL) were significantly lower than those of control group (4.94+/-0.21 g/dL). The hemoglobin, reticulocyte counts, and LD levels in study group were significantly different from those of control group (P<0.01), but the free fatty acid concentrations showed no difference between two groups. The free fatty acid/albumin molar ratio in study group was significantly higher than control values. In study group, there were significant correlations between the free fatty acid/albumin molar ratio and (a) LD (r=0.43, P< 0.05), (b) relative reticulocyte count (r=0.39, P<0.05), and (c) hemoglobin (r=-0.31, P<0.01), respectively. The GPX and SOD activities in study group were not statistically different from the control values. There was an inverse correlation between albumin and GPX concentrations in study group (r=-0.36, P<0.01). CONCLUSIONS: These results suggest that toxic effect of unbound free fatty acid with decreased albumin activity as antioxidant may be involved in the cellular injury in hypoalbuminemia patients. Further studies for the correlation of free fatty acid/albumin molar ratio with individual antioxidant status are needed.
Antioxidants ; Erythrocytes* ; Fatty Acids, Nonesterified ; Glutathione Peroxidase ; Humans ; Hypoalbuminemia* ; L-Lactate Dehydrogenase ; Molar* ; Oxygen ; Reticulocyte Count ; Superoxide Dismutase

Osteoporotic vertebral compression fractures have become common in aging societies and can lead to a decreased quality of life with severe back pain and neurological deficits.Traditional direct decompression and stabilization surgeries can produce sufficient decompression and provide good results. However, after surgical treatment, some elderly patients with numerous chronic diseases often experience severe postoperative complications owing to the long surgery duration and massive bleeding. Therefore, to prevent perioperative morbidity, other surgical methods that simplify the surgical process and reduce the operation time are required. Herein, we describe a case of indirect decompression using ligamentotaxis and sequential anabolic agents. To examine their effectiveness during surgery, we monitored intraoperative motor-evoked potentials. The patient’s neurological symptoms improved postoperatively. After the operation, the anabolic agent “romosozumab” was injected monthly to treat osteoporosis, prevent additional fractures, and accelerate posterolateral fusion. On serial follow-up, the anterior body height of the fractured vertebra improved significantly, demonstrating the importance of osteoporosis treatment using anabolic agents.Indirect decompression surgery may have early effects, whereas sequential anabolic agent use may consolidate the long-term effects of surgical treatment.

The molecular mechanism of the cell-cycle machinery in uterine leiomyoma has not yet been fully elucidated. Among the various types of cell-cycle regulators, p27(Kip1)(p27) is considered to be a potent tumor suppressor. To provide further molecular basis for understanding the progression of uterine leiomyoma, our objective was to evaluate the expression level of p27 in normal myometrium and uterine leiomyoma tissue and its effect on cytogenic growth. Western blot analysis, real-time polymerase chain reaction (PCR) and immunohistochemical staining revealed that p27 protein and messenger RNA were down-regulated in uterine leiomyoma tissue and cultured cells compared to normal myometerium. Full-length human p27 cDNA was transferred using a replication-deficient recombinant adenoviral vector (Ad.p27) into uterine leiomyoma cells and evaluated the effect on cell proliferation. Transfection of Ad.p27 into uterine leiomyoma cells resulted in the induction of apoptosis, reduction in viability and proliferation of uterine leiomyoma cells. Our results suggest a new paradigm that down-regulated p27 protein expression is the possible underlying mechanism for the growth of uterine leiomyoma and over-expression of p27 induces cell death. This study provides better understanding of the control exerted by p27 in regulating growth and disease progression of uterine leiomyoma.
Adult ; Cell Cycle ; Cell Proliferation ; Female ; Humans ; Intracellular Signaling Peptides and Proteins/antagonists & inhibitors/genetics/*physiology ; Leiomyoma/*pathology ; Middle Aged ; RNA, Messenger/analysis ; Uterine Neoplasms/*pathology

Induction of apoptosis in target cells is a key mechanism by which chemotherapy promotes cell killing. The purpose of this study was to determine whether Indole-3-Carbinol (I3C) and Genistein in combination with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induce apoptosis in endometrial cancer cell (Ishikawa) and to assess apoptotic mechanism. The MTT assay and flow cytometry were performed to determine cell viability and cell cycle. The induction of apoptosis was measured by caspase-3 activity test, DNA fragmentation assay, annexin V binding assay and western blot analysis. There was no effect in cell growth inhibition and cell cycle progression alone or in two-combination. However, the treatment of I3C and Genistein followed by TRAIL showed significant cell death and marked increase in sub-G1 arrest. Three-combination treatment revealed elevated expression of DR4, DR5 and cleaved forms of caspase-3, caspase-8, PARP. The Flip was found down regulated. Moreover, increase in caspase-3 activity and DNA fragmentation indicated the induction of apoptosis. The results indicate that I3C and Genistein with TRAIL synergistically induced apoptosis via death receptor dependent pathway. Our findings might provide a new insight into the development of novel combination therapies against endometrial cancer.
Anticarcinogenic Agents/*pharmacology ; Apoptosis/*drug effects ; Caspase 3/metabolism ; Caspase 8/metabolism ; Cell Line, Tumor ; Drug Synergism ; Endometrial Neoplasms/metabolism/pathology ; Female ; G1 Phase Cell Cycle Checkpoints/drug effects ; Genistein/*pharmacology ; Humans ; Indoles/*pharmacology ; Poly(ADP-ribose) Polymerases/metabolism ; Receptors, TNF-Related Apoptosis-Inducing Ligand/metabolism ; TNF-Related Apoptosis-Inducing Ligand/*pharmacology

The adequacy of the urologist work force in Korea has never been investigated. This study investigated the geographic distribution of urologists in Korea. County level data from the National Health Insurance Service and National Statistical Office was analyzed in this ecological study. Urologist density was defined by the number of urologists per 100,000 individuals. National patterns of urologist density were mapped graphically at the county level using GIS software. To control the time sequence, regression analysis with fitted line plot was conducted. The difference of distribution of urologist density was analyzed by ANCOVA. Urologists density showed an uneven distribution according to county characteristics (metropolitan cities vs. nonmetropolitan cities vs. rural areas; mean square=102.329, P<0.001) and also according to year (mean square=9.747, P=0.048). Regression analysis between metropolitan and non-metropolitan cities showed significant difference in the change of urologists per year (P=0.019). Metropolitan cities vs. rural areas and non-metropolitan cities vs. rural areas showed no differences. Among the factors, the presence of training hospitals was the affecting factor for the uneven distribution of urologist density (P<0.001).Uneven distribution of urologists in Korea likely originated from the relatively low urologist density in rural areas. However, considering the time sequencing data from 2007 to 2012, there was a difference between the increase of urologist density in metropolitan and non-metropolitan cities.
Cities/statistics & numerical data ; Health Services Accessibility/*statistics & numerical data/trends ; Korea/epidemiology ; Physicians/*supply & distribution/trends ; Republic of Korea/epidemiology ; Rural Health Services/*manpower/statistics & numerical data/trends ; Rural Population/statistics & numerical data/trends ; Urban Health Services/*manpower/statistics & numerical data/trends ; Urology/*manpower/*statistics & numerical data/trends

OBJECTIVES: We examined the effects of INM 176 (K-1107) compared with placebo on the cognitive functions of 92 old aged subjects with cognitive impairment. METHODS: This was a prospective, 12 week, double-blind, placebo-controlled clinical trial. The elderly who achieved a score of less than 25 points on the K-MMSE or showed a high risk of Alzheimer's disease from the 7-Minute Neurocognitive Screening Battery were considered to have objective impairment and were selected as subjects for this study. The subjects were randomized to placebo or INM 176 group. The outcome measures were from the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), the Instrumental Activities of Daily Living (IADL) and the Korean Geriatric Depression Scale (KGDS) and two kinds of computerized priming tests. After setting the total error score in the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog) as the repeated measurement factor, an analysis of variance of the combined factor design was done between the placebo and INM 176 group. RESULTS: The interaction effect of time (pre- and post- trial) and group (placebo and INM 176 group) was significant in the analysis of the ADAS-cog's total error score. The INM 176 group's total error score in the ADAS-cog decreased significantly (p<0.01), whereas the placebo group showed a slight increase. The mean changes in IADL and GDS from baseline scores favored in the INM 176 group than in the placebo group. Outcome changes of ADAS-cog, IADL, KGDS scores during the 12 week clinical trail of INM 176 and placebo demonstrated favorable responses in the INM176 administered group. CONCLUSIONS: This is a preliminary clinical trial result of INM176 as a memory pill. Based on these results, INM176 may be a candidate molecule for the improvement of cognitive functions, including memory. Further clinical trial should demonstrate its efficacy.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Depression ; Humans ; Mass Screening ; Memory* ; Outcome Assessment (Health Care) ; Prospective Studies

Objective: : The purpose of this study is identify the operation status of the neurosurgical care units (NCUs) in neurosurgical residency training hospitals nationwide and determine needed changes by comparing findings with those obtained from the Korean Neurosurgical Society (KNS) and Korean Society of Neurointensive Care Medicine (KNIC) survey of 2010.Method : This survey was conducted over 1 year in 86 neurosurgical residency training hospitals and two neurosurgery specialist hospitals and focused on the following areas : 1) the current status of the infrastructure and operating systems of NCUs in Korea, 2) barriers to installing neurointensivist team systems, 3) future roles of the KNS and KNIC, and 4) a handbook for physicians and practitioners in NCUs. We compared and analyzed the results of this survey with those from a KNIC survey of 2010. Results: : Seventy seven hospitals (87.5%) participated in the survey. Nineteen hospitals (24.7%) employed a neurointensivist or faculty member; Thirty seven hospitals (48.1%) reported high demand for neurointensivists, and 62 hospitals (80.5%) stated that the mandatory deployment of a neurointensivist improved the quality of patient care. Forty four hospitals (57.1%) believed that hiring neurointensivist would increase hospital costs, and in response to a question on potential earnings declines. In terms of potential solutions to these problems, 70 respondents (90.9%) maintained that additional fees were necessary for neurointensivists’ work, and 64 (83.1%) answered that direct support was needed of the personnel expenses for neurointensivists. Conclusion : We hope the results of this survey will guide successful implementation of neurointensivist systems across Korea.