BACKGROUND: Myocardial ischemia in human hypertension and in various animal models of hypertension may be due to abnormal maximal coronary vasodilator reserve and disturbaces of coronary vasomotion. The vascular reactivity defects in hypertension have been associated with the defective endothelium and sympathetic neural activation. However, such abnormalities in hypertension need to be elucidated. In the present study the effectsof cardiac ischemia reperfusion on coronary circulation, intramyocytic adenylates and purine nucleosides were examined in Langendorff-perfused Sprague Dawley rat (SD) and spontaneously hypertensive rat (SHR) hearts. Coronary venous and cardiac lactate and cardiac pyruvate were also measured. It should be noted that in the regulation of coronary flow the intrinsic flow autoregulation is highly variable due to coexisting metabolic flow control, and that natural coronary flow and cardiomyocytic energy state are normally reciprocally related in perfused heart. METHODS: For the Langendorff heart perfusion, bicarbonate perfusion buffer (pH 7.40+/-0.02,37degrees C) was equilibrated with 95% O2 : 5% CO2 and contained 5mM glucose (+5U/1 insulin) and 2mM pyruvate as energy-yielding substrates. Global hypoperfusion ischemia was induced by lowering coronary perfusion pressure of 100 to 40 cmH2O, followed by 20 min reperfusion. RESULTS: During the ischemia and reperfusion, metabolic acidosis and enhanced venous lactate output in SHR were observed with increases in coronary vascular resistance and myocardial oxygen consumption.In addition, coronary reactive hyperemia during reperfusion was depressed. Although ischemia-induced increase in combined adenosine plus inosine were abolished during prolonged reperfusion, SD still exhibited coronary vasodilation. The depressed reactive hyperemia in SHR was associated with decreases in cardiac adenosine triphosphate (ATP) pool and creatine phosphate/inorganic phosphate (CrP/Pi) ratio and an increase in cardiac lactate/pyruvate ratio. CONCLUSION: This abnormal vascular reactivity during ischemia and reperfusion in SHR may be in part due to an alteration in the cardiac energy state and hence to a mismatch between myocardial metabolic demand and supply.
Acidosis ; Adenosine ; Adenosine Triphosphate ; Animals ; Coronary Circulation ; Creatine ; Endothelium ; Glucose ; Heart* ; Homeostasis ; Humans ; Hyperemia ; Hypertension ; Inosine ; Ischemia ; Lactic Acid ; Models, Animal ; Myocardial Ischemia ; Oxygen ; Perfusion* ; Purine Nucleosides ; Pyruvic Acid ; Rats ; Rats, Inbred SHR* ; Reperfusion ; Vascular Resistance ; Vasodilation

BACKGROUND: Acute dissection of the thoracic aorta can mimic the symptoms of myocardial infarction with pain, elevated serum creatinine kinase levels, and electrocardiographic abnormalities suggesting myocardial ischemia. Therefore, this study was designed to assess the clinical differences between a thoracic aortic dissection and an acute myocardial infarction. METHODS: The cases of 72 patients who visited the Emergency Department, Dankook University Hospital, from January 1996 to December 1998 were retrospectively reviewed. Of the 72 patients, 32 were thoracic aortic dissections and 40 were acute myocardial infarctions. The parameters analyzed were epidemiology, pain character and associated symptoms, simple X-rays, EKGs on arrival. RESULTS: This study demonstrated that 1) there were significant differences in the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-rays, and the EKGs between the two groups and that 2) there were no significant differences in pain severity and abrupt onset. CONCLUSION: This study suggests that patients with suspected acute myocardial infarction should be provided an appropriate, accurate technique, such as CT, MRI, or TEE, if the nature, location, and duration of pain, the radiation, the neurologic symptoms, the chest X-ray, and the EKG are consistent with a thoracic aortic dissection.
Aorta, Thoracic ; Creatinine ; Electrocardiography ; Emergency Service, Hospital ; Epidemiology ; Humans ; Magnetic Resonance Imaging ; Myocardial Infarction* ; Myocardial Ischemia ; Neurologic Manifestations ; Phosphotransferases ; Retrospective Studies ; Thorax

No abstract available.
Adult* ; Doxycycline ; Humans ; Tooth*

PURPOSE: The purpose of this study was to investigate the relationships among self-efficacy, collective efficacy, job satisfaction, and organizational commitment of nurses working in general hospitals. METHODS: Data were collected from 239 nurses working in five general hospitals of a local area by self-reported questionnaires. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation, and hierarchial multiple regression. RESULTS: Self-efficacy, collective efficacy, job satisfaction, and organizational commitment showed significantly positive correlations. Hierarchial multiple regression analysis showed that self-efficacy was the main factor of affecting job satisfaction, which explained 14.3% of the variance for the nurses' job satisfaction together with collective efficacy and weekly working time. In addition, the primary factor of affecting organization commitment was self-efficacy, which accounted for 17.2% of the variance for the nurses' organizational commitment together with hospital size and shift work. CONCLUSION: Self-efficacy and nursing working condition such as working time or hospital size contributed to the job satisfaction and organizational commitment and collective efficacy contributed to the job satisfaction. Therefore, the strategies for improving self and collective efficacy should be considered. Further study is also needed to investigate the concept of collective efficacy and its' measurement, and the relationship between collective efficacy and organizational commitment.
Health Facility Size ; Hospitals, General ; Job Satisfaction* ; Nursing ; Surveys and Questionnaires

No abstract available.
Coronary Circulation* ; Heart* ; Rats, Inbred SHR*

The purpose of this study was to examine the effects of mouth care on the relief of oral discomfort undergoing radiation therapy patients. The nonequivalent control group time series design was used for this experimental study. The subjects were 32 patients who were receiving radiation therapy at P, D, G, hospital in Pusan from July 1, 1996 to August 31 1996. Among 32 subjects, 16 were placed in the experimental group and 16 in the control group. The subjects were contacted at the hospital, given an explanation of the study, and asked them to participate. The experimental group was educated according to oral care protocol. The data were collected through interviews, observations, and the health care records of the patients. The instruments were the "Perceived Oral Symptoms Assessment" by Chung, C. W. and "Oral Assessment Guide(OAG)" by Elers, Berger, & Petersen. SPSS PC+ was used to analyze the collected data. The general characteristics were analyzed by frequency, percentage, mean and standard deviations. The homogeneties between the experimental groups and control groups were tested by t-test and chi-square test. Perceived oral symptoms & OAG were tested by mean and standard deviations. The results of this research can summarized as follows : 1. Between two groups, the differences of perceived oral symptoms were not statistically significant (t=.0035, p=.9634). 2. In time series analysis the differences of perceived oral symptoms between two groups in the 7th week were only significant(t=5.0123, p=.0491). 3. The comparisons of each item in perceived oral symptoms, the differences between two groups were observed but they were not statistically significant. 4. Between two groups, the differences of OAG were not significant statistically(t=.0221, p=.8827). 5. In time series analysis, the differences of OAG between two groups were no statistically significant. 6. The comparisons of each item in OAG, the differences between two groups were observed but they were not statistically significant. In conclusion, this study could be utilized in patients care with radiation therapy although the results of the experiment were not accepted statistically.
Busan ; Delivery of Health Care ; Humans ; Mouth*

This study was conducted to analyze the relations among nutritional knowledge, nutritional attitude eating practice and total nutritional diagnosis and also to find the influencing factors of them. The survey was done during the period from April 1990 to June 1990 and the target population were Ewha Woman's University students (freshmen and senior) of whom 1,354 peoples were surveyed. The summarized results are as follows ; 1. For the learning environment, the percentage of completion on nutritional knowledge course was 28.6% and among them the department of foods and nutrition had the highest score(100.0%) and the next was dept. of medicine(53.4%). 2. To find the relation which the nutritional knowledge, nutritional attitude, eating practice and the total nutritional diagnosis influence on one another, the multiple correlation analysis was done. The attitude the practice were highly correlated with total nutritional diagnosis, but the correlation between nutritional knowledge and total nutritional diagnosis was not significant. The correlation between the practice and nutritional knowledge which were positively and significantly correlated with attitude respectively was positive but not significant. 3. The difference which were analyzed by department, grade and completion on knowledge course on the nutritional knowledge, attitude, eating practice were significant (p<0.01) by ANOVA. 4. The significant variables on nutritional diagnosis are the eating practice points, the grade, the knowledge course, the breakfast and the attitude (r2=10.3%) by multiple regression analysis. This study has the limitation that it did not consider the environmental factors of dietary life such as dietary culture, family environment, cultural habit. Therefore important points of these dietary studies are to extend to the practical nutritional education and dietary improvement for the national health not restricted to the local area or local population.
Attitude ; Breakfast ; Diagnosis ; Eating* ; Education ; Female ; Health Services Needs and Demand ; Humans ; Learning

Since 1983, the transtrochanteric rotational osteotomy has been performed in 38 hips of 36 patients for the nontraumatic avascular necrosis of the femoral head at the department of orthopaedic surgery of Seoul National University Hospital. Out of them, 26 hips(18 cases of Sugioka grade I and 8 cases of Sugioka grade II ) were followed up for more than 1 year. The average period of follow-up was 3 years and 5 months(range, 1 year and 2 months to 7 years). These cases include 3 cases of failure before 2 years after operation. Overall, the result was satisfactory in 20 cases(77%)out of a total of 26 cases(success in 18 cases(69%)and good in 2 cases(8%)). The results of the grade I lesions(14 cases of success and 1 case of good result out of 18 cases) were better than those of the grade I lesions(4 cases of success and 1 case of good result out of 8 cases). Complications occurred in 5 cases. These include an ectopic ossification, a stress fracture of the neck, a nonunion of the osteotomy site, a nonunion of the greater trochanter and a delayed union of the greater trochanter. There were 6 cases of failure. For the 4 cases of them, hip replacement arthroplasy was performed. The MRI images axial to the longitudinal axis of the femoral neck gave excellent information for the operation.
Femur ; Femur Neck ; Follow-Up Studies ; Fractures, Stress ; Head ; Hip ; Humans ; Magnetic Resonance Imaging ; Neck ; Necrosis ; Ossification, Heterotopic ; Osteotomy ; Seoul

OBJECTIVE: To compare the clinical outcomes of intrauterine insemination (IUI) according to the catheter used. MATERIALS AND METHOD: From March 1998 to September 1998, total 95 infertile patients were included in this study. Patients were randomly allocated to TomCat group (n = 39) and Mackler group (n = 56) according to the catheter for insemination. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone agonist (GnRH-a) was used in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose and duration of exogeneous gonadotropin required were similar between the two groups. There were also no significant differences in serum estradiol (E2) level, endometrial thickness and texture on the day of hCG administration between the two groups. However, the percentage of uterine souding due to failure of initial approach was significantly higher in TomCat group compared to Mackler group (23.1% vs. 0%, p < 0.01). The percentage of bleeding after IUI in TomCat group seemed to be higher than that in Mackler group (15.4% vs. 3.6%, p = 0.06), although there was no statistically significant difference between the two groups. There was also no significant difference in the clinical pregnancy rate per patient between the two groups. CONCLUSION: These results suggested that using Mackler catheter might be effective for IUI, especially for the patients with cervical factor infertility.
Catheters* ; Estradiol ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Infertility ; Insemination* ; Pregnancy Rate

For many years, members of medical profession have believed that the shorter symptoms to diagnosis interval(SDI) might be related to early stages and that the prompt treatments might improve survival rates in cancer patients. But this notion has been challenged by many researches for many years. This study was conducted to investigate the effects of SDI on the cancer survival for 221 stomach cancer cases, 106 lung cancer cases, 74 liver cancer cases and 59 cervix cancer cases. These cancer cases are registered ones in Kanghwa Cancer Registery Program from 1987 to 1991. Relationships among SDI, stages of cancers, operation rates, and survival were analysed. Results are as follows: 1. SDI was not related to stages of cancer. There were no difference in the distribution of stages among five SDI subgroups. 2. This data did not support that SDI affects the survival of stomach cancer patients. The cancer stages did affect survival in stomach cancer patients though. 3. Our data did not support that SDI affects cancer survival. A Cox proportional hazard model showed that SDI does not play a important role in cancer survival controlling age, gender, stage and other variables in the model. Further studies are highly expected to clarify the relationships between SDI and cancer survivals. Researches with bigger sample size and more sophisticated variables would be needed.
Diagnosis* ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Proportional Hazards Models ; Sample Size ; Stomach Neoplasms ; Survival Rate ; Uterine Cervical Neoplasms