BACKGROUND: The regurgitative valvular heart diseases are important underlying diseases that result in congestive heart failure, and the prevalence increase with the increasing age. Early detection and management of the regurgitative valvular heart disease could decrease the morbidity and mortality rate of the elderly. METHODS: We reviewed medical records of 425 patients who visited KonKuk University Medical Center ChungJu Hospital for the echocardiography between April 1994 to September 2000. 281 out of 425 patients were diagnosed with regurgitative valvular heart disease, and they were analyzed according to their age, sex, underlying disease, and accompaniment of congestive heart failure. Also the relationships between the regurgitative valvular heart disease and fractional shortening(FS), and also with ejection fraction(EP) were analyzed. RESULTS: There were 281 patients diagnosed with regurgitative valvular heart disease. Greatest number of patients was diagnosed with MR, followed by AR, TR and PR, accordingly. The prevalence of regurgitative valvular heart disease increased as the age increased. The prevalence of regurgitative valvular heart disease in male patients were 74% and for female patients, 62%. For patients with hypertension, it was 59%, and for DM patients it was 60%. For patients with past history of ischemic heart disease, or congestive heart failure, the prevalences of regurgitative valvular heart disease were high. FS for the patients with regurgitative valvular heart disease was 28.91% compared 32.69% for the patients without regurgitative valvular heart disease. EF for the patients with regurgitative valvular heart disease was 54% compared to the 60% for without regurgitative valvular heart disease. The FS for patients with symptomatic regurgitative valvular heart disease was 23.86% compared to 27.7% for asymptomatic group. The EF for symptomatic regurgitative valvular heart disease was 46.2% compared to 52.3% for asymptomatic group. CONCLUSION: When 2D-echocardiography was performed on elderly patients who were older than 65 years of age, most of them featured degenerative structural changes in valves and deterioration of valvular functions resulting in regurgitative valvular heart disease. When patients had any symptoms or underlying diseases, the decrease in cardiac function and high prevalence of regurgitative valvular heart disease were apparent. Therefore in elderly patients, even if they are asymptomatic or without any underlying diseases, aggressive diagnostic approaches and early intervention may delay the progress of valvular heart disease.
Academic Medical Centers ; Aged* ; Chungcheongbuk-do ; Early Intervention (Education) ; Echocardiography ; Female ; Heart Failure ; Heart Valve Diseases* ; Humans ; Hypertension ; Male ; Medical Records ; Mortality ; Myocardial Ischemia ; Prevalence

In transmembrane and intracellular sites of neurom, calcium ion(Ca(++)) has been known to have an important role of signalling process. It is naw well accepted that calcium binding proteins, calbindin D-28K (calbindin) and parvalbumin, modulate and mediate above aclcium ionss action as a second messenger. Although it has been reported that calbindinergic and parvalbuminergic neurons comprise different subpopulations in the cat and rat spinal cords, the studies of their morphology, topographical distribution and ultrastructural features have not been done extensively in the mammalian spinal cords until now. This study was conducted to localize calbidinergic and parvalbuminergic neurons and to define their morphology, topographical distribution and ultrastructural features in the rabbit cervical cord by the preembedding immunocytochemical method using anti-calbindin and anti-parvalbumin antisera. In the rabbit cervical cord, calbindin immunoreactive neurons were mainly distributed in the dorsal horn, especially in lamina II, and a smaI1 number of labelled neurons were observed in the intermediate gray matter (IGS), but calbindin immunoreactivities were not observed in the intermediate gray substance(IGS), but calbindin immunoreactiveties were not observed in thr ventral horn. The somata of calbindin immunoreactive neurons received synaptic inputs from non-immunoreactive axon terminals in the dorsal horn and in the IGS. Parvalbumin immunoreactive neurons were mainly observed in the IGS and in the ventral horn, but only a few of parvalbumin immunoreactive neurons were distributed in the dorsal horn. In the ventral horn, two types of parvalbumin immunoreactive neurons were identified according to the sizes of the somata and labelled motor cells received synaptic inputs from labelled and unlabelled axon terminals. These results demonstrate that calbindinergic neurons are a number of neurons located in lamina II of dorsal horn and a few of neurons located in the intermediate gray and parvalbuminergic ne.urons are laocated in the intermediate gray substance and in the ventral horn, and these neurons comprise different subpopulations of neurons. It was suggest that calbindinergic neurons might play an important role in the process of pain modulation and parvalbumiergic neurons in the control of motor activity with their specific synaptic circuitry in the spinal cord.
Animals ; Calbindins ; Calcium ; Calcium-Binding Proteins ; Cats ; Horns ; Immune Sera ; Motor Activity ; Neurons* ; Presynaptic Terminals ; Rats ; Second Messenger Systems ; Spinal Cord

No abstract available.
Cystatin C* ; Hemoglobin A, Glycosylated* ; Humans

PURPOSE: The purpose of this study was to describe feelings and actions of nurses following withdrawal of life-sustaining treatment from children being cared for by the nurses. METHODS: Data were collected by in-depth interviews with 7 nurses from different hospitals where children receiving nursing care had life-sustaining treatment withdrawn. The interviews were conducted from August 2016 to February 2017 when all data were saturated. Interviews lasted 30~90 minutes and were conducted 2~3 times per participant. Data were analyzed using Giorgi's phenomenological research methodology. RESULTS: The following factors constituted experiences of nurses working in pediatric wards when life-sustaining treatment was withdrawn from children: “agony and conflict in the aspects of care”, “heavy mind and regret for exhausting care”, “intentionally avoiding parents' sadness”, “comforting sadness in the heart” and “orientation in the role of caring for children undergoing withdrawal of life-sustaining treatment.” CONCLUSION: Findings indicate that support systems and intervention programs need to be developed so that nurses can understand and wisely deal with experiences of withdrawal of life-sustaining treatment from children who receive care from nurses.
Child* ; Humans ; Nursing Care ; Pediatric Nursing ; Qualitative Research ; Research Design ; Withholding Treatment

No abstract available.
Adipokines ; Diabetes, Gestational ; Female ; Humans ; Insulin Resistance ; Insulin ; Pregnancy ; Pregnant Women

Purpose: The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. Methods: Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé ́ test, Pearson correlation coefficients, and multiple regression. Results: It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. Conclusion The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

OBJECTIVE: The purpose of this study was to compare with pregnant and non-pregnant women for homocysteine and vitamin B12 and to determine effecting factors on serum homocysteine and vitamin B12 level. METHODS: From March 2001 to February 2002, 202 pregnant (24-28 wks) women and 237 non- pregnant women were included in this study. Blood sample for homocysteine, vitamin B12, folate and questionaires about life style and nutrition were done. Homocysteine was measured by HPLC and vitamin B12, folate were measured by RIA. RESULT: Concentrations (mean+/-8D) of homocysteine and vitamin B12 in pregnant women were 8.2+/-3.1 micromol/L, 449.4+/-212.3 pg/ml, and in non-pregnant women were 12.5+/-6.3 micromol/L, 1017.1+/-296.8 pg/ml, respectively. Risk group of homocysteine was 6.5% in pregnant women (n=12/185), and 26.4% in non- pregnant women (n=57/216). In pregnant women, homocysteine have a negative correlation with folate, vitamin B12 (p<0.05). Non- pregnant women were divided to three groups (smoker, ever been smoker but stop smoking now, non- smoker) and concentrations of homocysteine were 13.6+/-7.0, 13.0+/-6.7, 11.9+/-7.6 micromol/L, respectively. They were divided to two groups (drinker, non-drinker) and concentrations of homocysteine were 12.9+/-7.0, 10.4+/-3.0 micromol/L respectively (p<0.05). Pregnant women who take nutrients have a higher concentration of folate than in women do not (8.8+/-5.1 vs. 7.9+/-3.9 pg/ml, p<0.05). CONCLUSION: Homocysteine in women during pregnancy is decreased by about 35% compared with that of non-pregnant women. In pregnant women, as homocysteine increases, as folate and vitamin B12 decrease. Among the non-pregnant women, higher level of homocysteine demonstrated in smokers than in non-smokers and in drinkers than non-drinkers. In pregnant women who take nutrients have a significant higher level of folate than do not, but have no significant relationship in homocysteine level.
Chromatography, High Pressure Liquid ; Female ; Folic Acid ; Homocysteine* ; Humans ; Life Style ; Pregnancy ; Pregnant Women ; Smoke ; Smoking ; Vitamin B 12* ; Vitamins*

OBJECTIVE: This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. METHODS: Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. RESULTS: The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. CONCLUSIONS Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.

We investigated the effect of low dose radiation on diabetes induced suppression of neurogenesis in the hippocampal dentate gyrus of rat. After 0.01 Gy, 0.1 Gy, 1 Gy and 10 Gy radiation was delivered, the dentate gyrus of hippocampus of streptozotocin (STZ)-induced diabetic rats were evaluated using immunohistochemistry for 5-bromo-2-deoxyuridine (BrdU), caspase-3, and terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL) staining. The number of BrdU positive cells in the non-diabetic rats, diabetic rats without radiation, diabetic rats with 0.01 Gy radiation, diabetic rats with 0.1 Gy radiation, diabetic rats with 1 Gy radiation and diabetic rats with 10 Gy radiation were 55.4+/-8.5/mm2, 33.3+/-6.4/mm2, 67.7+/-10.5/mm2, 66.6+/-10.0/mm2, 23.5+/-6.3/mm2 and 14.3+/-7.2/mm2, respectively. The number of caspase-3 positive cells was 132.6+/-37.4/mm2, 378.6+/-99.1/mm2, 15.0+/-2.8/mm2, 57.1+/-16.9/mm2, 191.8+/-44.8/mm2 and 450.4+/-58.3/mm2, respectively. The number of TUNEL-positive cells was 24.5+/-2.0/mm2, 21.7+/-4.0/mm2, 20.4+/-2.0/mm2, 18.96+/-2.1/mm2, 58.3+/-7.9/mm2, and 106.0+/-9.8/mm2, respectively. These results suggest low doses of radiation paradoxically improved diabetes induced neuronal cell suppression in the hippocampal dentate gyrus of rat.
Rats, Sprague-Dawley ; Rats ; Radiotherapy/methods ; Neurons/*metabolism ; Male ; In Situ Nick-End Labeling ; Hippocampus/*cytology/metabolism/radiation effects ; Diabetes Mellitus, Experimental/radiotherapy ; Dentate Gyrus/drug effects/*radiation effects ; Cell Proliferation ; Caspase 3/metabolism ; Bromodeoxyuridine/pharmacology ; Apoptosis ; Animals

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare conditon with an estimated incidence of 1 in 30,000 pregnancies in a natural cycle. But the incidence of heterotopic pregnancies has been increased because of rising incidence of pelvic inflammatory disease, pelvic surgery, intrauterine device, the use of various ovulation induction and assisted reproductive technologies, such as in vitro fertilization and embryo transfer, gamate intrafallopian insemination. The early diagnosis of heterotopic pregnancy is very difficult. So there is a higher maternal morbidity, mortality and fetal loss. Thus careful pelvic examination, combined with serial beta hCG determinations and transvaginal sonography to evaluate the adnexal region are important. We experienced a case of 34-years-old multiparous women with heterotopic pregnancy in natual cycle confirmed by surgical removal of ruptured right tubal pregnancy and sonographic finding of the intrauterine pregnancy, which carried the intrauterine pregnancy to term delivery without complication at 39+5 weeks of gestation, and report this case with a brief review of the literature.
Early Diagnosis ; Embryo Transfer ; Female ; Fertilization in Vitro ; Fertilization* ; Gynecological Examination ; Humans ; Incidence ; Insemination ; Intrauterine Devices ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Reproductive Techniques, Assisted ; Ultrasonography