Anthrax toxin consists of three separate proteins, protective antigen (PA), edema factor (EF), and lethal factor (LF). PA binds to the receptor on mammalian cells and facilitates translocation of EF or LF into its cytosol. PA is the primary component of anthrax vaccines. In this study we purified PA from culture filtrates of Bacillus anthracis. The purification involved sequential chromatography through hydroxylapatite, DEAE-Sepharose CL-4B, followed by Mono-Q. The purified PA was judged to be homogeneous on SDS-PAGE, and consisted of a single polypeptide chain with a relative molecular weight of 85,000.
Anthrax ; Anthrax Vaccines ; Bacillus anthracis* ; Bacillus* ; Chromatography ; Cytosol ; Durapatite ; Edema ; Electrophoresis, Polyacrylamide Gel ; Molecular Weight

PURPOSE: The aim of this study was to determine the influence of various factors on preterm labor symptoms (PLS) and preterm birth (PB). METHODS: This prospective cohort study included 193 women in the second stage of pregnancy. Multiple characteristics including body mass index (BMI), smoking, and pregnancy complications were collected through a self-report questionnaire. Pregnancy stress and PLS were each measured with a related scale. Cervical length and birth outcome were evaluated from medical charts. Multiple regression was used to predict PLS and logistic regression was used to predict PB. RESULTS: Multiple regression showed smoking experience, pregnancy complications and pregnancy specific stress were predictors of PLS and accounted for 19.2% of the total variation. Logistic regression showed predictors of PB to be twins (OR=13.68, CI=3.72~50.33, p<.001), shorter cervix (<25mm) (OR=5.63, CI=1.29~24.54, p<.05), BMI >25 (kg/m²) (OR=3.50, CI=1.35~9.04, p<.01) and a previous PB (OR=4.15, CI=1.07~16.03, p<.05). CONCLUSION: The results of this study show that the multiple factors affect stage II pregnant women can result in PLS or PB. And preterm labor may predict PB. These findings highlight differences in predicting variables for pretrm labor and for PB. Future research is needed to develop a screening tool to predict the risk of preterm birth in pregnant women.
Body Mass Index ; Cervical Length Measurement ; Cervix Uteri ; Cohort Studies ; Female ; Humans ; Logistic Models ; Mass Screening ; Obstetric Labor, Premature* ; Parturition ; Pregnancy ; Pregnancy Complications ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women ; Premature Birth* ; Prospective Studies ; Smoke ; Smoking ; Twins

PURPOSE: This study attempted to understand patients' and nurses' perspectives on the priority of rehabilitation nursing services using Importance-Performance Analysis (IPA). METHODS: This study used descriptive research design. Data were collected from 121 patients and 144 nurses using self-reported questionnaires. Statistical analysis included an independent t-test, analysis of variance (ANOVA), and IPA conducted using SPSS/WIN 21.0 version. RESULTS: There were no statistical differences between the patients' and nurses' mean scores on perceptions of the importance (t=-0.83, p=.409) and performance (t=-0.32, p=.751) of rehabilitation nursing services. The IPA matrix showed a difference between patients and nurses in terms of their perceived priority of nursing services. Regarding the perception of patients, "helping a patient to continue to practice bedside physiotherapy and occupational therapy", "providing information on the proper care agency and community resources", and "providing education for the prevention of complications" fell in the "concetrate here" area (2nd quadrant). CONCLUSION: The results showed that the priorities of patients and nurses did not match in terms of some of the rehabilitation nursing services. Thus, rehabilitation nursing services need to be provided based on the patients' needs. Allocation of resources for the service items that fell in the "concentrate here" area of the IPA need be reconsidered for the quality in nursing care.
Education ; Humans ; Nursing Care ; Nursing Services ; Rehabilitation Nursing* ; Rehabilitation* ; Research Design ; Resource Allocation

PURPOSE: There are some disagreements about the optimal dosages of intravenous gammaglobulin(IVGG) and oral aspirin(ASA) in the treatment of Kawasaki disease. So authors performed a prospective clinical study to evaluate the efficacy of IVGG 1g/kg plus ASA 50mg/kg/day. METHODS: We treated 29 patients who were admitted to Inha University Hospital from June 1993 through May 1994 with IVGG 1g/kg plus ASA 50mg/kg/d. We compared the outcomes of above patients with those of two other groups of patients, group A and B in authors' previous study. Group A(20 patients) had been treated with IVGG 2g/kg plus ASA 50mg/kg/d and group B(19 patients) with IVGG 2g/kg plus ASA 100mg/kg/d. The outcomes had been similar in group A and B, which was published on this journal in 1995 (vol. 38:378-385). RESULTS: 1) Twenty five patients(86.2%; group C) were given only one dose of IVGG 1g/kg, and remaining 4 patients(13.8%; group D) were given two doses of IVGG 1g/kg because of persistent high fever. 2) The age and sex distributions, durations of fever before treatment, and durations of ASA therapy in group C were not significantly different from those in group A and B (p>0.05). 3) Laboratory findings on admission in group C were not significantly different from those in group A and B, except that the mean ESR was lower in group C than in group A and B (35.1+/-19.8 vs 55.5+/-5.95 & 50.2+/-11.4mm/hr; p<0.01, respectively). 4) The durations of fever after treatment in group C were not significantly different from those in group A and B (1.32+/-1.07 vs 2.65+/-3.28 & 1.74+/-1.52 days; p>0.05, respectively). 5) In group C, the mean hemoglobin concentration at the 3rd week of illness was higher than in group A (11.1+/-0.98 vs 10.1+/-1.24g/dl; p<0.05), the mean platelet count at the 2nd week of illness was lower than in group A (59.4+/-18.0x10(4) vs 73.6+/-19.0x10(4)/ l; p<0.05), and the mean ESRs at the 2nd and 3rd week of illness were lower than in group A (43.3+/-14.7 vs 54.0+/-9.16, 31.9+/-19.0 vs 47.7+/-13.0mm/hr; p<0.05, respectively). Other follow-up laboratory findings in group C were not significantly different from those in group A and B. 6) Echocardiography was done 2 and 4 weeks after onset of illness. Coronary arterial dilation was observed in four(4/25; 16%) and two(2/23; 8.7%) patients respectively in group C, and the proportions were not significantly different from those in group A(40% & 25%) and B(31.6% & 10.5%) (p>0.05, respectively). In follow-up examinations, coronary aneurysm was observed in only one(1/23; 4.3%) in group C, which was similar to group A(1/18; 5.5%) and B(1/19; 5.2%) (p>0.05, respectively). Giant aneurysm was not observed in any patients. 7) Four patients(group D) were given one more dose of IVGG 1g/kg because high fever persisted 48 hours after injection of the first dose of IVGG. Afterthen fever subsided within 1 to 7 days. Echocardiography revealed mild coronary arterial dilation in two patients initially, but follow-up examinations revealed no coronary aneurysm. CONCLUSIONS: The medium-dose combined regimen with IVGG 1g/kg plus ASA 50mg/kg/d seems to be more cost-effective than the high-dose regimen with IVGG 2g/kg plus ASA 50-100mg/kg/d. If high fever persists 48 hours or more after the first dose of IVGG 1g/kg, it is desirable to give one more dose of IVGG 1g/kg.
Aneurysm ; Aspirin* ; Coronary Aneurysm ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Platelet Count ; Prospective Studies ; Sex Distribution

BACKGROUND: Iron deficiency still remains the most common single nutrient deficiency disorder in the world, especially among young children and adolescent girls. As little is recently known about iron deficiency in infants and preschool children in Korea, this study is aimed to determine the prevalence of iron deficiency in healthy population and to determine the proportion of children in whom iron deficiency goes undetected using the current screening technique. METHODS: We collected venous samples from 410 apparently healthy preschool children during March to June, 1997, as a part of a regular health check-up program. We measured hemoglobin, hematocrit, mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), serum ferritin, serum iron, and total iron binding capacity(TIBC). RESULTS: A total of 410 infants and preschool children aged 1~6 years were included in this study. The prevalence of anemia was 7.9%(3/38) in infants and children aged 1~2 years, 6.3%(12/190) in 3~4 years and 1.6%(3/182) in 5~6 years. The prevalence of iron deficiency(ferritin <10 ng/mL or transferrin saturation <10%) was 31.6%(12/38) in 1~2 years, 23.7%(45/190) in 3~4 years and 14.3%(26/182) in 5~6 years. The prevalence of IDA was 5.3% (2/38) in 1~2 years, 1.1% (2/190) in 3~4 years and 0.5%(1/182) in 5~6 years. Microcytic anemia was found in only 2 cases, both of which is included in 1~2 years of age. CONCLUSION: The prevalence of iron deficiency and IDA was relatively high in 1~2 years of age, critical period for neurologic development. Nutritional education including iron fortification for mothers having caring babies especially of this age group should be warranted.
Adolescent ; Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool* ; Critical Period (Psychology) ; Education ; Female ; Ferritins ; Hematocrit ; Humans ; Infant ; Iron* ; Korea ; Mass Screening ; Mothers ; Prevalence* ; Transferrin

PURPOSE: We usually measure the changes of peak expiratory flow rate (PEFR) or forced expiratory volume in one second (FEV1) to check the bronchial response after inhalation of bronchodilator. Airway resistance determined by interrupter technique (Rint) is simple and easily applicable even to the infant. A comparison among PEFR, FEV1 and Rint was done to find out the feasibility of using Rint instead of PEFR or FEV1 in checking the bronchial response after inhalation of bronchodilator. METHODS: We checked PEFR, FEV1, Rint, and oxygen saturation with twenty eight asthmatic children, over 7 years old, visited emergency or out patient department with acute asthmatic attack. The same parameters were checked in 5, 10, 20 minutes after inhalation of bronchodilator. Comparison and relationship of measures as well as changes of measures after inhalation of bronchodilator among them were analyzed to confirm if Rint can replace PEFR or FEV1 in checking bronchial response after inhalation of bronchodilator. RESULTS: PEFR, FEV1 and O2 saturation increased as time goes on but airway resistance decreased. The relationship among the changes of parameters of PEFR, FEV1 and Rint checked in 5, 10 and 20 minutes after inhalation of bronchodilator showed close correlation with was statistically significant. But, the measures checked in 20 minutes after inhalation statistically insignificant. CONCLUSION: Rint can be used instead of PEFR and FEV1 in checking the bronchial response after inhalation of bronchodilator.
Airway Resistance* ; Child ; Emergencies ; Forced Expiratory Volume* ; Humans ; Infant ; Inhalation ; Oxygen ; Peak Expiratory Flow Rate* ; Respiratory Function Tests

No abstract available.
Humans*

PURPOSE: To compare the clinical results of short-term visual acuity and quality of vision after implantation of a yellow-tinted blue light-filtering intraocular lens (IOL) (Acrysof IQ® SN60WF) and an clear ultraviolet (UV) light filtering IOL (enVista™ MX60) in the same patient. METHODS: 44 patients with bilateral cataract received an SN60WF in one eye and an MX60 in the other eye. All eyes were evaluated for refraction power and uncorrected visual acuity (UCVA) at preoperative and 1, 3 months postoperatively. At postoperative 3 months, corrected visual acuity, quality of vision (OQAS II®), contrast sensitivity (CGT 2000®) and visual field (Humphrey Field Analyzer®), and subjective patients' response to the degree of brightness were evaluated. Furthermore, glistening degree, intraocular stability, and posterior capsular opacification were examined. RESULTS: There were no significant differences in average refractive power or UCVA at 1 and 3 months (p > 0.05) between the two groups. At 3 months after cataract surgery, the quality of vision according to OQAS II®, the contrast sensitivity according to CGT 2000® with the glare either on or off, and visual field; showed no difference between the two groups (p > 0.05). Both IOLs had no glistening and posterior capsular opacity. The patients' response to the degree of brightness shows that MX60 (48.3%) has a higher degree of satisfaction. CONCLUSIONS: Yellow-tinted blue light-filtering IOL and clear UV light-filtering IOL had no difference in short-term visual acuity and quality of vision. Subjective brightness perception, however, was better with clear UV light-filtering IOL.
Cataract ; Contrast Sensitivity ; Glare ; Humans ; Lenses, Intraocular* ; Visual Acuity ; Visual Fields

OBJECTIVE: About 40% of patients who admit to the hospital after subarachnoid hemorrhage are poor clinical grade(Hunt-Hess grade IV, V). The majority of these patients have been excluded from early, aggressive treatment. The current study was undertaken to evaluate the outcome of urgent surgery for Hunt-Hess grade IV aneurysmal subarachnoid hemorrhage. MATERIALS AND METHODS: We reviewed hospital records and radiographic studies of 36 patients who were Hunt-Hess grade IV among 201 cases with ruptured intracranial aneurysm admitted between Sep. 1995 and Dec. 2000. Operated patients were treated with urgent angiography and surgery within 24 hours of presentation, except six patients, and medical records of these patients were reviewed for the clinical course and Glasgow outcome scale(GOS). RESULTS: Overall management results of the 36 patients were good recovery in 13(36.1%), moderate disability in 12 (33.3%), severe disability in 1(2.8%), vegetative state in 1(2.8%) and 9(25.0%) of surgically treated patients had died. CONCLUSION: Although with limited number of patients, we conclude that urgent surgery for Hunt-Hess grade IV patients results in a better neurologic outcome and urgent surgery combined with aggressive postoperative management can minimize mortality.
Angiography ; Hospital Records ; Humans ; Intracranial Aneurysm* ; Medical Records ; Mortality ; Persistent Vegetative State ; Subarachnoid Hemorrhage

Two cases of incomplete transverse vaginal septum with a small opening in the upper third of vagina were presented. One case was a patient presenting at 31 years of age for evaluation of primary infertility and oligomenorrhea. Diagnosis was made by hysterosalpingography, tranvaginal ultrasonography, MRI, and diagnostic pelviscopy for evaluation of abnormality of endopelvic organs. The patient was treated with surgical resection of septum (simple septectomy). Examination 3 months later demonstrated narrowing of the vaginal lumen. Another case was a patient presenting intrauterine pregnancy at 8 weeks and 2 days accompanying transverse vaginal septum with small opening. She had previous septotomy history and presented postoperative scarring. She had septectomy and anastomosis of the mucosa, and presented postoperative narrowing again about a month postoperatively. In this report we describe the two cases of transverse vaginal septum. We also reviewed the literature including diagnostic and treatment guidelines. Prevention of postoperative scarring is the most important factor in management of transverse vaginal septum. For that, first of all, initial septectomy should be done with approximation of the mucosa and postoperative dilatation is necessary. Importance of the initial accurate septectomy is too important to be over-emphasized.
Cicatrix ; Constriction, Pathologic* ; Diagnosis ; Dilatation ; Female ; Humans ; Hysterosalpingography ; Infertility ; Magnetic Resonance Imaging ; Mucous Membrane ; Oligomenorrhea ; Pregnancy ; Ultrasonography ; Vagina