PURPOSE: In this study, relationships between symptom experience and quality of life in a cross-sectional sample of patients with Atrial Fibrillation (AF) were investigated. METHODS: This descriptive study involved a convenience sample of AF patients from S university hospital, C city. One hundred and two AF patients completed psychometric validated measures of AF related symptoms and quality of life. Descriptive statistics and Pearson correlation coefficients with SPSS WIN 14.0 were used for data analysis. RESULTS: Of 16 atrial arrhythmia-related symptoms, the patients reported 'tiredness' as the most frequent and 'shortness of breath' as the most severe. The level of overall quality of life for patients with AF was 53.92. There were significant differences in symptom frequency according to religion, New York Heart Association (NYHA) classification and left ventricular ejection fraction ; symptom severity according to monthly income and stroke ; quality of life according to age, job, alcohol intake, NYHA class and stroke. Quality of life for these patients was positively correlated with symptom frequency and symptom severity. CONCLUSIONS: This study demonstrated that patients with more frequent and severe symptoms perceive poorer quality of life than patients with less frequent and less severe symptoms. Symptom experience should be assessed early to improve quality of life for patients.
Atrial Fibrillation ; Heart ; Humans ; New York ; Psychometrics ; Quality of Life ; Statistics as Topic ; Stroke ; Stroke Volume

A questionnaire on a variety of ophthalmic topics was made up and sent to 150 members of the Korean Society of Cataract and Refractive Surgery-[KSCRS] in May, 1996. Forty percent [60/150] responded within the deadline in June, 1996. As the contents of the questionnaire were almost identical to the ones prepared in the USA [1994, 1995] and in Japan [1994], the answer to the questionnaire could be compared with those gathered from the USA and Japan. Over half of the respondents [57%] were in their forties. The average number of operations done per month was 26. Cataract operation accounted for over 60% of the total operations in 34% of KSCRS members. And more than 76% of the cataract operation were done using phacoemulsification technique in 31% of the respondents. There were no difference in the preferred method of local anesthesia for the cataract surgery in Korea compare to the USA or Japan. And there was less likelihood of using peribulbar anesthesia and no suture technique in Korea compared to the USA. Sixty-one percent of the Korean ophthalmic surgeon implanted the intraocular lenses even before the patients were younger than 20 years old whereas, 82% of ophthalmic surgeon in Japan did only when the patients were older than 20 years of age. For radial keratotomy as a means of correcting myopia, 91% of the Korean respondents were not performing the procedure any more, while 45% of the American respondents abandoned it. Fifty four percent of the Korean respondents and 46% of the American respondents have been doing excimer laser photorefractive keratectomy. There was no statistical difference between the two. From the answers to the qustionnaire, we found that our results did not differ significantly from those of the USA or Japan and we believe that these results reflect the present trends of cataract and refractive surgeries in Korea.
Anesthesia ; Anesthesia, Local ; Cataract* ; Surveys and Questionnaires ; Humans ; Japan ; Keratotomy, Radial ; Korea ; Lasers, Excimer ; Lenses, Intraocular ; Myopia ; Phacoemulsification ; Photorefractive Keratectomy ; Refractive Surgical Procedures* ; Suture Techniques ; Young Adult

BACKGROUND: Adrenal medullary transplants into the subarachnoid space have been demonstrated to reduce pain sensitivity. This analgesia most likely results from the release of neuroactive substances, particularly catecholamines and opioid peptides from the transplanted cells into spinal cord. METHODS: Isolated bovine chromaffin cells were encapsulated with alginate and poly-L-lysine prior to implantation into rat's subarachnoid space to protect them from host immune system. And then catecholamines from encapsulated chromaffin cells were measured quantitatively in vitro by High Performance Liquid Chromatograph. The animals were randomized into 2 groups, one of which received microencapsulated chromaffin cells and the other empty capsules. The effects of such implants were evaluated on the pain behavior resulting from a chronic constriction injury of the rat sciatic nerve for 30 days. RESULTS: Catecholamine concentration in cerebrospinal fluid (CSF) was analyzed. Data (mean SD) are considered significant at P <0.05 (ANOVA for repeated measure and Dunnett's test). Continuous release of catecholamine and met-enkephalin with responsiveness to nicotine stimulation was measured from encapsulated cells in vitro. A significant reduction of allodynic response to acetone evaporation was observed in the animals implanted with cell loaded capsules compared to control animals with empty capsules. Catecholamine concentration in CSF was higher in the cell loaded capsule group. There were no complications related to implantation. CONCLUSION: We found that encapsulated chromaffin cells released continuously catehcolamines and opioids peptides in vitro and in the CSF. Those results may prove chromaffin cell's anagesic effect indirectly.
Acetone ; Analgesia ; Analgesics, Opioid ; Animals ; Capsules ; Catecholamines* ; Cerebrospinal Fluid ; Chromaffin Cells* ; Constriction ; Drug Compounding ; Enkephalin, Methionine ; Immune System ; Nicotine ; Opioid Peptides ; Peptides ; Rats ; Sciatic Nerve ; Spinal Cord ; Subarachnoid Space

To analyze the developmental changes in soma diameters of digastric motoneurons, wheat-germ agglutinin conjugated horseradish peroxidase (WGA-HRP) was injected into the digastric muscle and visualized the retrogradely HRP-labeled motoneurons through tungstate/tetramethylbenzidine (TMB) and following diaminobenzidine (DAB) reactions. The results obtained from Sprague-Dawley rats at postnatal days 1 (P1), 10 (P10) and 30 (P30) indicated as follows: firstly, soma diameters of digastric motoneurons showed unimodal distribution in all postnatal days examined; secondly, the period of P1 to P10 (period 1) showed about 2 times faster growth rate than that of P10 to P30 (period 2); thirdly, the smallest soma examined in each postnatal day exhibited slower growth rate with that of the largest one (increase ratio in soma diameters from P1 to P30, smallest vs. largest =1.62 : 1.93); Finally, relative growth rates a day showed again that period 1 had faster growth rate than that of period 2. Consequently, developmental changes in soma diameters of digastric motoneurons resulted in very different growth rates between both periods. This implies that the growth of the soma is almost completing within P10 and thereafter growing slowly. The period 1 and 2 are corresponding to sucking and sucking/masticatory period, respectively. Therefore present study providing morphological changes in soma diameters of digastric motoneurons suggests that both periods and their different growth rates of the motoneurons in each period may closely be related with each other.
Animals ; Carisoprodol* ; Horseradish Peroxidase ; Rats* ; Rats, Sprague-Dawley

Extraction and fractionation of Pulsatilla koreana flowers followed by, repeated open column chromatography for EtOAc and n-BuOH fractions yielded four flavonoid glycosides, namely, astragalin (1), tiliroside (2), buddlenoide A (3), and apigenin-7-O-(3"-E-p-coumaroyl)-glucopyranoside (4). The chemical structures of these flavonoid glycosides were elucidated on the basis of various spectroscopic methods including electronic ionization mass spectrometry (EI-MS), 1D NMR (1H, 13C, DEPT), 2D NMR (gCOSY, gHSQC, gHMBC), and infrared (IR) spectrometry. This study represents the first report of the isolation of the flavonoid glycosides from the flowers of P. koreana.
Chromatography ; Flowers* ; Glycosides* ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Pulsatilla* ; Spectrum Analysis

Nevus lipomatosus cutaneous superficialis is a very rare disorder characterized by nevoid fatty growth in the dermis. It usually arises in the pelvic girdle, so is unfamiliar to most otolaryngologists. A case of a 72-year-old male with nevus lipomatosus cutaneous superficialis in the nasal cavity is presented with a brief review of the disease.
Aged ; Dermis ; Humans ; Male ; Nasal Cavity ; Nevus*

Synovial sarcoma is a rare renal neoplasm that is not easy to diagnose unless SYT-SSX fusion transcripts are identified. We report here on a case of primary renal synovial sarcoma in a 35-year-old woman. A mass was discovered by accident in the lower part of the right kidney when ultrasonography was performed, and it was removed via radical nephrectomy. Grossly, the tumor was a homogeneously tan-brown soft mass that measured 4.5x3.2x3.0 cm, and it was encircled by a well-defined cystic space. The lesion exhibited hypercellularity of the oval or short spindle cells that were arranged in various solid sheets or intersecting fascicles. Immunohistochemically, the tumor showed diffuse positivity for vimentin, bcl-2 and CD99, and it showed focal positivity for epithelial membrane antigen. The SYT-SSX fusion transcripts were detected by reverse transcription-polymerase chain reaction (RT-PCR). Synovial sarcoma should be considered in the differential diagnosis when a spindle cell neoplasm is encountered in the kidney.
Adult ; Diagnosis, Differential ; Female ; Humans ; Kidney ; Kidney Neoplasms ; Mucin-1 ; Nephrectomy ; Oncogene Proteins, Fusion ; Sarcoma, Synovial ; Vimentin

BACKGROUND: The combination of local anesthetics and opioids in the spinal anesthesia has a synergic analgesic effect. Therefore, we compared intraoperative conditions and clinical effects of low dose (5 mg) bupivacaine added with fentanyl versus a conventional dose(10 mg) of bupivacaine in spinal anesthesia for a transurethral resection of the prostate (TURP). METHODS: Forty five ASA class 1 and 2 patients scheduled for a TURP were randomly divided into three groups. Group B (n = 15) received bupivacaine 10 mg, group BF (n = 15) received bupivacaine 5 mg added with fentanyl 20microgram, and group BFE received bupivacaine 5 mg added with fentanyl 20microgram and 0.2 mg epinephrine. Blood pressure and heart rate were recorded every 5 minutes before and after spinal anesthesia. Sensory blockade was measured by a pin-prick test and motor blockade was evaluated by the Bromage motor scale. Side effects including pruritus, nausea, vomiting, respiratory depression, and intraoperative pain were observed. RESULTS: The duration of sensory and motor blockade in group BF was significantly shorter than in group B and group BFE (P<0.05). Without statistical significance, hypotension (6.7%) and bradycardia (13.3%) were observed in group B and pruritus (26.7%) and nausea (13.3%) occurred in all patients who received fentanyl. CONCLUSIONS: The addition of fentanyl 20microgram to low dose bupivacaine 5 mg resulted in short lasting motor and sensory block, compared with conventional dose bupivacaine 10 mg. Therefore, we concluded that the clinical application of this method could provide adequate analgesia with early discharge and no serious side effects for TURP patients.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal* ; Anesthetics, Local ; Blood Pressure ; Bradycardia ; Bupivacaine* ; Epinephrine ; Fentanyl* ; Heart Rate ; Humans ; Hypotension ; Nausea ; Prostate* ; Pruritus ; Respiratory Insufficiency ; Transurethral Resection of Prostate ; Vomiting

PURPOSE: This study evaluated mid-term results of anterior cruciate ligament (ACL) reconstruction using the PINN-ACL CrossPin system that allowed for short graft fixation. MATERIALS AND METHODS: Forty-three patients underwent single-bundle ACL reconstruction with a 4-strand semitendinosus tendon graft using the PINN-ACL CrossPin system. Femoral fixation was done using the PINN-ACL CrossPin system, and the tibial side was fixed with post-tie and a bioabsorbable interference screw. The mean follow-up period was 50 months. Evaluation was done using the Lachman test, pivot-shift test, International Knee Documentation Committee (IKDC) score and grade. Anterior displacement was assessed. RESULTS: There was improvement in the Lachman test and pivot-shift test at final follow-up, form grade II (n=40) or III (n=3) to grade I (n=3) or 0 (n=40) and from grade I (n=20) or II (n=10) to grade I (n=8) or 0 (n=22), respectively. The mean IKDC score was 88.7, and grade A and B were 93.0% at final follow-up. Side-to-side difference was improved from 6.7 mm to 2.1 mm at final follow-up. Complications occurred in 3 patients, a re-ruptured due to trauma at 2 years after surgery and a deep infection and a superficial infection. CONCLUSIONS: The mid-term follow-up results of ACL reconstruction with the PINN-ACL CrossPin system were satisfactory. The PINN-ACL CrossPin can be considered as a useful instrument for short graft fixation.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Follow-Up Studies ; Humans ; Knee ; Tendons ; Transplants

PURPOSE: Sclerostin, an inhibitor of Wnt/beta-catenin signaling, exerts negative effects on bone formation and contributes to periodontitis-induced alveolar bone loss. Recent studies have demonstrated that serum sclerostin levels are increased in diabetic patients and that sclerostin expression in alveolar bone is enhanced in a diabetic periodontitis model. However, the molecular mechanism of how sclerostin expression is enhanced in diabetic patients remains elusive. Therefore, in this study, the effect of hyperglycemia on the expression of sclerostin in osteoblast lineage cells was examined. METHODS: C2C12 and MLO-Y4 cells were used in this study. In order to examine the effect of hyperglycemia, the glucose concentration in the culture medium was adjusted to a range of levels between 40 and 100 mM. Gene expression levels were examined by quantitative reverse transcription-polymerase chain reaction and Western blot assays. Top-Flash reporter was used to examine the transcriptional activity of the beta-catenin/lymphoid enhanced factor/T-cell factor complex. Tumor necrosis factor-alpha (TNFalpha) protein levels were examined with the enzyme-linked immunosorbent assay. The effect of reactive oxygen species on sclerostin expression was examined by treating cells with 1 mM H2O2 or 20 mM N-acetylcysteine. RESULTS: The high glucose treatment increased the mRNA and protein levels of sclerostin. High glucose suppressed Wnt3a-induced Top-Flash reporter activity and the expression levels of osteoblast marker genes. High glucose increased reactive oxygen species production and TNFalpha expression levels. Treatment of cells with H2O2 also enhanced the expression levels of TNFalpha and sclerostin. In addition, N-acetylcysteine treatment or knockdown of TNFalpha attenuated high glucose-induced sclerostin expression. CONCLUSIONS: These results suggest that hyperglycemia increases sclerostin expression via the enhanced production of reactive oxygen species and TNFalpha.
Acetylcysteine ; Alveolar Bone Loss ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Glucose ; Humans ; Hyperglycemia* ; Necrosis* ; Osteoblasts ; Osteogenesis ; Oxygen* ; Periodontitis ; Reactive Oxygen Species ; RNA, Messenger ; Tumor Necrosis Factor-alpha