Black adenoma is known to be a rare variant of adrenal cortical adenoma containing characteristic abundant lipofuscin pigments in the cytoplasm. Almost all of them are nonfunctioning and only occasionally they are associated with Cushing's syndrome or primary hyperaldosteronism. We present two cases of black cortical adenoma of the adrenal gland associated with Cushing's syndrome in a 24-year-old woman and a 64-year-old man. This report dealt with clinical and pathologic presentation including ultrastructural identification of lipofuscin pigment.
Female ; Male ; Humans ; Adenoma

PURPOSE: The purpose of this study was to determine characteristics of nursing science and identify expected outcomes from baccalaureate graduates, and to develop accreditation standards and criteria reflecting the characteristics of the nursing profession. METHODS: A methodological research design was utilized in this study. Related literature reviews and the nursing education program goals and objectives of the 99 nursing schools in Korea were analyzed. A cross-sectional survey research design was utilized to test the validity of the developed characteristics of the nursing profession and their accreditation criteria and standards. The face validity was from the advisory committee and public committee hearing. RESULTS: The characteristics of nursing science were defined with five concepts including humanity, scientific knowledge, professionalism, therapeutic relationship, and facilitating well-being. The expected outcomes from graduates were identified as providing holistic nursing, critical thinking, establishing professionalism and leadership, construction of a therapeutic relationship, and skilled nursing practice. Finally6 standards and 14 criteria reflecting the unique characteristics of the nursing profession were developed for accreditation. These proposed accreditation standards and criteria are a challenge to promote the quality of nursing science.
Accreditation/organization & administration/*standards ; Cross-Sectional Studies ; Curriculum/standards ; Education, Nursing, Baccalaureate/organization & administration/*standards ; Humans ; Nursing Methodology Research ; Organizational Objectives

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol versus oral dinoprostone for labor induction at term. METHODS: One hundred of patients at term were randomized to receive either 50microgram of misoprostol vaginally every 4 hours or dinoprostone 0.5mg orally every 1 hour for the maximum of six doses. Intravenous infusion of oxytocin was administered under such circumferences as the patient did not go into active labor after maximum dose, SROM was developed without an adequate contraction pattern, or the patient had arrest of dilatation(no change in cervical dilatation for 2 hours). We compared the frequency of oxytocin augmentation, administration to delivery interval, vaginal delivery rate within 12 hours and 24 hours, intrapartum complications, induction failure, mode of delivery, neonatal outcomes, and maternal complications between two groups. RESULTS: The average interval from administration to delivery was shorter in the misoprostol group(739.4+/-372.4min vs 1087.7+/-765.1min, p<0.05), but the interval from administration to vaginal delivery of each group was similar(724.3+/-375.4min vs 800.3+/-697.0min). Regarding the frequency of vaginal delivery within 24 hours, however, misoprostol group was higher than dinoprostone group(88% vs 56%, p<0.001). And oxytocin augmentation of labor occurred less commonly in misoprostol group than in dinoprostone group(20% vs 76%, p<0.05). Any statistically significant difference in intrapartum complications, mode of delivery, and neonatal or maternal adverse outcome was not appeared between these two group. CONCLUSION: Vaginal misoprostol is as effective and safe as oral dinoprostone for cervical ripening and induction of labor at term. In addition, vaginal misoprostol contributes the curtailment of labor induction expenditure due to its moderate price; misoprostol costs 100 won per 50microgram.
Cervical Ripening ; Dinoprostone* ; Female ; Health Expenditures ; Humans ; Infusions, Intravenous ; Labor Stage, First ; Misoprostol* ; Oxytocin ; Pregnancy

OBJECTIVES: The inhibitory effect of Dickkopf (Dkk)-1 on osteoblastic differentiation through blocking Wnt signaling has been well studied. However, the role of other members of the subfamily of Dkks remains unclear. We have examined the role of different Dkks on osteoblastic differentiation of mesenchymal progenitor cells and apoptosis of osteoblasts. METHODS: Osteoblastic differentiation was induced by treatment of Wnt-3a with Dkks or vehicle in C3H10T1/2 cells and alkaline phosphatase (ALP) activity was measured. Serum deprivation induced apoptosis was performed with pre-treatment of Dkks or vehicle in MC3T3-E1 cells and methyl thiazolyl tetrazolium (MTT) assay was done. RESULTS: Dkk-2 at low concentrations (5 and 20 nM) and Dkk-3, -4 at any concentrations (5 to 100 nM) significantly increased Wnt-3a-induced ALP activity, whereas Dkk-2 at high concentration (100 nM) significantly reduced. Treatment of Dkk-2, -3 and -4 at high concentration (100 nM) showed significant decreases of Wnt/beta-catenin transcriptional activity, whereas no effects were seen at low concentration (20 nM). In parallel experiments, treatment of Dkk-1 showed robust dose dependent inhibition not only in ALP activity but also in Wnt/beta-catenin transcriptional activity. Dkk-2, -3 and -4 increased serum deprivation-induced apoptosis in MC3T3-E1 mouse osteoblasts, while Dkk-1 had no effect. CONCLUSIONS: We found that unlike Dkk-1, Dkk-3 and -4 stimulated early osteoblastic differentiation at various concentrations regardless of their inhibitory effects on Wnt/beta-catenin transcriptional activity at high concentration. Dkk-2 had a biphasic effect where the lower doses significantly increased ALP activity while the high dose was inhibitory. Dkk-2, -3 and -4 stimulated osteoblast apoptosis whereas Dkk-1 had no effect.
Alkaline Phosphatase ; Animals ; Apoptosis ; Mesenchymal Stromal Cells ; Mice ; Osteoblasts

Cholinesterase (ChE) is one of the most ubiquitous enzymes and in addition to its well characterized catalytic function, the morphogenetic involvement of ChE has also been demonstrated in neuronal tissues and in non-neuronal tissues such as bone and cartilage. We have previously reported that during mouse tooth development, acetylcholinesterase (AChE) activity is dynamically localized in the dental epithelium and its derivatives whereas butyrylcholinesterase (BuChE) activity is localized in the dental follicles. To test the functional conservation of ChE in tooth morphogenesis among different species, we performed cholinesterase histochemistry following the use of specific inhibitors of developing molar and incisors in the hamster from embryonic day 11 (E11) to postnatal day 1 (P1). In the developing molar in hamster, the localization of ChE activity was found to be very similar to that of the mouse. At the bud stage, no ChE activity was found in the tooth buds, but was first detectable in the dental epithelium and dental follicles at the cap and bell stages. AChE activity was found to be principally localized in the dental epithelium whereas BuChE activity was observed in the dental follicle. In contrast to the ChE activity in the molars, BuChE activity was specifically observed in the secretory ameloblasts of the incisors, whilst no AChE activity was found in the dental epithelium of incisors. The subtype and localization of ChE activity in the dental epithelium of the incisor thus differed from those of the molar in hamster. In addition, these patterns also differed from the ChE activity in the mouse incisor. These results strongly suggest that ChE may play roles in the differentiation of the dental epithelium and dental follicle in hamster, and that morphogenetic subtypes of ChE may be variable among species and tooth types.
Acetylcholinesterase ; Ameloblasts ; Animals ; Butyrylcholinesterase ; Cartilage ; Cholinesterases ; Cricetinae ; Dental Sac ; Epithelium ; Incisor ; Mice ; Molar ; Morphogenesis ; Neurons ; Tooth ; Tooth Germ

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system associated with longitudinally extensive myelitis and optic neuritis. It is characterized by relapses that lead to blindness and paralysis sequelaes. But, this is rare disease; therefore high clinical suspicion for a correct diagnosis and proper examinations are not easy. However, early diagnosis is essential to prevent sequelae. We report the case of NMO with headache. A 30-year male patient who suffered headache visited our pain clinic because of aggravated pain despite treatment. The cause of the pain was revealed as NMO by more detailed previous history and examination.
Blindness ; Central Nervous System ; Demyelinating Diseases ; Diagnosis ; Early Diagnosis ; Headache ; Humans ; Male ; Myelitis ; Neuromyelitis Optica* ; Optic Neuritis ; Pain Clinics ; Paralysis ; Post-Traumatic Headache* ; Rare Diseases ; Recurrence

Inflammation is the basis of severe acute and chronic diseases. This study investigated the anti-inflammatory property of a crude methanol extract (MeOH-ex) and the solvent fractions of Ixeris dentata Nakai (IDN) in LPS-stimulated murine macrophage-like cell line RAW264.7. Here, we showed that the ethyl acetate fraction (EtOAc-fr) had the most potent inhibitory activity on LPS-induced nitric oxide (NO) production among the tested samples, i.e., IDN MeOH-ex and the three different solvent fractions (chloroform, n-hexane, and EtOAc). We further found that the EtOAc-fr significantly inhibited LPS-induced prostaglandin PGE2 (PGE2) generation in RAW264.7 cells. Furthermore, the treatment with EtOAc-fr effectively suppressed the expression of inducible NO synthase (iNOS) and cyclooxygenase 2 (COX-2). These results suggest that the EtOAc-fr of IDN MeOH-ex exhibits an anti-inflammatory activity in vitro by inhibiting LPS-induced NO production and PGE2 generation via suppression of iNOS and COX-2 expression.
Asteraceae* ; Cell Line ; Chronic Disease ; Cyclooxygenase 2 ; Dinoprostone* ; Inflammation ; Methanol ; Nitric Oxide Synthase ; Nitric Oxide*

There have been reports of abnormalities in the lumbosacral region involving a lower-than-normal termination of the dural sac, which is caused by disease or anatomical variation. Inadvertent dural puncture or other unexpected complications can occur during caudal epidural block or adhesiolysis in patients with these variations, but only a small number of case reports have described this issue. We report a case of dural puncture by the introducer needle before attempting caudal epidural adhesiolysis, which occurred even though the needle was not advanced upward after penetrating the sacrococcygeal ligament. Dural puncture was caused by a morphological abnormality in the lumbosacral region, with no pathological condition; the dural sac terminal was located more distally than normal. However, dural puncture could have been prevented if we had checked for such an abnormality in the magnetic resonance imaging (MRI) taken before the procedure.
Humans ; Ligaments ; Lumbosacral Region ; Magnetic Resonance Imaging ; Needles ; Punctures

We describe two cases of multiple lymphomatous polyposis in the gastrointestinal tract from the esophagus to the rectum. Clinical findings, histopathologic and immunohistochemical findings in paraffin embedded tissue are discussed. It is important to recognize this rare form of gastrointestinal lymphoma because of the prognostic and therapeutic implications.
Antigens, CD/analysis ; Gastrointestinal Neoplasms/immunology/*pathology ; Humans ; Immunohistochemistry ; Intestinal Polyps/immunology/*pathology ; Lymphoma/immunology/*pathology ; Male ; Middle Aged ; Polyps/immunology/*pathology

PURPOSE: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. METHODS: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. RESULTS: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. CONCLUSION: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.
Diarrhea/complications/etiology ; Enteral Nutrition/*methods/standards ; Female ; Heart Diseases/*surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Nutritional Requirements ; *Postoperative Care/methods ; Postoperative Complications ; Program Development ; Program Evaluation