BACKGROUND: Thromboembolism is the major complication in patients with the insertion of cardiac prosthetic valves. The purpose of this study is evaluate the risk factors about the formation of left atrial thrombi after cardiac valve replacement. METHOD: Transesophageal(TEE) and transthoracic echocardiography(TTE) were done to evaluate postoperative cardiac condition in 98 patients with cardiac prosthetic valves from Jan. 1991 to Oct 1991. Several clinical and echocardiographic parameters were analyzied to evaluate the relationship with the formation of left atrial thrombi. RESULT: In univariate analysis, important factors related to the formation of left atrial thrombi are type of operation (p=0.027), postoperative left ventricular function(p=0.003), preoperative(p=0.037) and postoperative systolic ventricular size(p=0.024). However, in multivariate analysis postoperative left ventricular size(p=0.017), presence of previous thrombi(p=0.014), preoperative left atrial size(p=0.014) and postoperative left atrial size(p=0.014) are significant factors. CONCLUSION: Patients with high risk and low risk for the formation of left atrial thrombi after valve replacement can be identified by readily available clinical and echocardiographic variables.
Echocardiography ; Heart Valves ; Humans ; Multivariate Analysis ; Risk Factors* ; Thromboembolism

The skin functions as a physical barrier against entry of pathogens while concomitantly supporting a myriad of commensal organisms. The characterization of these microbial communities has enhanced our knowledge of the ecology of organisms present in normal skin, and studies have begun to illuminate the intimate relationship between the host and resident microbes. The cutaneous innate and adaptive immune responses can modulate skin microbiota, while simultaneously, the microbiota educates the host immune system. A crucial element of the innate immune response is mast cells, which reside strategically in tissues that are commonly exposed to the external environment, such as the skin and mucosae. Mast cells are present on the frontline of defense against pathogens, suggesting they may play an important role in fostering the host-microbiota relationship. In this review, we highlight findings regarding the interaction between skin microbiota and mast cells and the resulting outcomes in skin homeostasis.
Architectural Accessibility ; Ecology ; Foster Home Care ; Homeostasis ; Immune System ; Immunity, Innate ; Mast Cells* ; Microbiota* ; Mucous Membrane ; Skin*

The skin functions as a physical barrier against entry of pathogens while concomitantly supporting a myriad of commensal organisms. The characterization of these microbial communities has enhanced our knowledge of the ecology of organisms present in normal skin, and studies have begun to illuminate the intimate relationship between the host and resident microbes. The cutaneous innate and adaptive immune responses can modulate skin microbiota, while simultaneously, the microbiota educates the host immune system. A crucial element of the innate immune response is mast cells, which reside strategically in tissues that are commonly exposed to the external environment, such as the skin and mucosae. Mast cells are present on the frontline of defense against pathogens, suggesting they may play an important role in fostering the host-microbiota relationship. In this review, we highlight findings regarding the interaction between skin microbiota and mast cells and the resulting outcomes in skin homeostasis.
Architectural Accessibility ; Ecology ; Foster Home Care ; Homeostasis ; Immune System ; Immunity, Innate ; Mast Cells* ; Microbiota* ; Mucous Membrane ; Skin*

Human mast cells are potent effector cells in host defense mechanisms of innate and acquired immunity, including inflammatory diseases such as asthma and atherosclerosis. Mast cells originate from pluripotent hematopoietic progenitors in the bone marrow. Activation of mast cells by different stimuli triggers the release of a large range of mediators, including de novo synthesized eicosanoids which are highly biologically active lipid mediators. For the generation of lipid mediators, cytoplasmic lipid droplets have been shown to function as a major intracellular pool of arachidonic acid, the precursor for eicosanoids biosynthesis. The article summarizes current knowledge on mast cell biosynthesis of lipid mediator and the role in inflammation.
Adaptive Immunity ; Arachidonic Acid ; Asthma ; Atherosclerosis ; Bone Marrow ; Cytoplasm ; Defense Mechanisms ; Eicosanoids ; Humans ; Inflammation ; Mast Cells*

No abstract available.
Animals ; Medulla Oblongata* ; Putrescine* ; Rats*

Neonatal adrenal hemorrhage is frequently associated with birth trauma or perinatal hypoxia. Hemorrhagic necrosis of the adrenal glands is often found at autopsy and many small lesions are usually asymptomatic. A palpable abdominal mass and jaundice are the usual presenting signs. Ultrasound is very useful in the diagnosis of this lesion; however, if the mass has mixed echoic pattern, magnetic resonance imaging (MRI) is helpful for the differential diagnosis from neuroblastoma. We present the case of a female newborn who was found to have a abdominal mass on physical examination. The patient showed anemia and hyperbilirubinemia. An ultrasonogram disclosed a 3.8 × 3.0 cm suprarenal mass with mixed echoic pattern. The mass was initially suspected to be neuroblastoma. An abdominal computed tomogram was not able to differentiate the mass. Magnetic resonance imaging revealed markedly increased signal intensity on T1 and T2-weighted sequences. This findLl1g was consistent with adrenal hemorrhage. Serial sonogram demonstrated the mass that resolved completely by 12 weeks of age.
Adrenal Glands ; Anemia ; Anoxia ; Autopsy ; Diagnosis ; Diagnosis, Differential ; Female ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant, Newborn ; Jaundice ; Magnetic Resonance Imaging ; Necrosis ; Neuroblastoma ; Parturition ; Physical Examination ; Ultrasonography

PURPOSE: The purpose of this study was to identify the relationships among professional self-concept, critical thinking disposition and clinical competence in nursing students. METHOD: The participants in the study were 505 nursing students, 262 associate degree nursing students and 243 baccalaureate nursing students, all in schools in Gwangju or South Jeonla Province. A questionnaire survey was conducted from April 25 to May 27, 2011. Statistical processing was performed with SPSS 18.0 Version and the data were analyzed using t-test, ANOVA, Scheffe test, Pearson correlation coefficients, and multiple stepwise regression. RESULTS: There was a positive correlation among clinical competence and professional self-concept, critical thinking disposition. The most effective factor for clinical competence was professional practice in professional self-concept, followed by prudence and objectivity in critical thinking disposition. The total explanation of clinical competence was 46.2%. CONCLUSION: The results of this study indicate confirm that professional self-concept and critical thinking disposition have an effect on clinical competence in nursing students. Accordingly in order to improve clinical competence, it is necessary to provide practice environment and educational curriculum that enhance the professional self-concept and critical thinking disposition of nursing students.
Clinical Competence ; Curriculum ; Humans ; Professional Practice ; Surveys and Questionnaires ; Self Concept ; Students, Nursing ; Thinking

BACKGROUND: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. METHODS: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 +/- 2.2 kg/m2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. RESULTS: The percent VF reduction was -23.4 +/- 17.2% in the LCD group and -9.8 +/- 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). CONCLUSION: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.
Caloric Restriction ; Diabetes Mellitus, Type 2 ; Glucose ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat ; Muscles ; Plasma ; Weight Loss

BACKGROUND: This study was performed to determine the biopsy sites that are suitable for the diagnosis of Helicobacter pylori infection and to assess the sensitivity of culture, histology, and dual-priming oligonucleotide (DPO)-based multiplex PCR. Moreover, we evaluated the usefulness of PCR for the detection of 23S rRNA mutations, which are responsible for the clarithromycin resistance of H. pylori. METHODS: From 90 patients, we obtained biopsy specimens for culture, histology, and Seeplex(R) ClaR-H. pylori PCR (Seegene Inc., Korea). Phenotypic susceptibility to clarithromycin was evaluated using the E-test (AB Biodisk, Sweden). RESULTS: H. pylori was detected in 48 of 90 patients. The positive rates of infection in the antrum and body were higher than those in the biopsies obtained from the duodenal bulb. The positive rates in histology, PCR, and culture were 46.7%, 42.2%, and 34.4%, respectively. Using histology or PCR, we identified H. pylori in 46 of the 48 patients. 23S rRNA mutations were detected in 8 patients. The clarithromycin E-test showed that all the 10 wild-type patients were susceptible. However, the results of the PCR and E-test of 3 of the 8 mutation-positive patients were discrepant. CONCLUSIONS: We observed that a combination of histology and PCR affords a high detection rate of H.pylori infection and that DPO-based PCR can be practically used for the diagnosis of H. pylori infection and the determination of clarithromycin resistance. These techniques were useful for biopsy sampling simultaneously from the antrum and body for the detection of clarithromycin resistance of multiple strain infection or heteroresistance.
Anti-Bacterial Agents/*pharmacology ; Biopsy ; Clarithromycin/*pharmacology ; Drug Resistance, Bacterial ; Genotype ; Helicobacter Infections/*diagnosis/drug therapy/pathology ; Helicobacter pylori/drug effects/genetics/*isolation & purification ; Humans ; Microbial Sensitivity Tests ; Mutation ; Polymerase Chain Reaction ; RNA, Ribosomal, 23S/genetics

BACKGROUND: Oral tolerance is defined by the inhibition of immune responsiveness to a protein previously exposed via the oral route. Protein antigens exposed via the oral route can be absorbed through the mucosal surfaces of the gastrointestinal tract and can make physical contact with immune cells residing in the intestinal lamina propria (LP). However, the mechanisms of oral tolerance and immune regulation in the intestines currently remain to be clearly elucidated. METHODS: In order to determine the effect of oral protein antigen intake (ovalbumin, OVA) on the intestinal LP, we assessed the expression profile of the T cell receptor and the co-receptors on the cells from the intestines of the tolerant and immune mouse groups. RESULTS: We determined that the proportion of OVA-specific B cells and gamma delta T cells had decreased, but the CD8alpha beta and CD8alpha alpha T cells were increased in the LP from the tolerant group. The proportion of CD8+ T cells in the spleen did not evidence any significant differences between treatment groups. CONCLUSION: These results indicate that CD8+ T cells in the intestinal LP may perform a regulatory role following antigen challenge via the oral route.
Animals ; B-Lymphocytes ; Gastrointestinal Tract ; Intestines ; Mice ; Mucous Membrane ; Ovalbumin ; Receptors, Antigen, T-Cell ; Spleen ; T-Lymphocytes