BACKGROUND AND OBJECTIVES: Pure pontine infarct is defined as an infarct limited to the pons without the evidence of any other brainstem infarct. This study was designed to assess the etiology, lesion topography, and clinical characteristics of pure pontine infarcts. METHODS: Sixty-six patients with pure pontine infarcts, shown on magnetic resonance imaging, were divided into three groups(Group I(n=32) : unilateral lesion reaching the ventral surface of the pons(>1.5cm in size), Group II(n=27) : single or multiple lesions, separated from the surface(<1.5cm), Group III(n=7) : bilateral extensive lesion reaching the ventral surface). Clinical characteristics including the risk factors and the symptomotology were evaluated. Conventional or magnetic resonance angiography was performed in 37 patients(Group I ; 18/32, Group II ; 14/27, Group III ; 5/7). RESULTS: Pontine lesions in Group I(number of lesions = 36) were located longitudinally in the upper (8/36, 22.2%), middle(11/36, 30.6%), and lower(17/36, 47.2%) pons. Thirty-seven patients, in whom angiography was performed, were classified etiologically in each groups. In Group I, fourteen patients had basilar artery branch disease and four had large artery disease. In Group II, all had small artery disease. In Group III, three patients had large artery disease and two had basilar artery branch disease. The most frequent risk factor in pure pontine infarct was hypertension in all three groups. CONCLUSION: The lower region of pons is the most vulnerable site of pure pontine infarct. Basilar artery branch disease was the most common cause of the pure pontine infarct(43.2%). Small artery disease occupied 37.8% and large artery disease(18.9%) was less common.
Angiography ; Arteries ; Basilar Artery ; Brain Stem ; Humans ; Hypertension ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Pons ; Risk Factors

PURPOSE: The purpose of this study was conducted to identify the impact of Symptom Severity and Symptom Interference on Sleep Disturbance among cancer patients. METHODS: This study was conducted from October 8th to October 25th, 2012. One hundred eight cancer patients were recruited from S city in Korea. The instruments used in this study were the Symptom Severity, Symptom Interference and the Sleep Disturbance scales for patients with cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 20.0 program. RESULTS: The Sleep Disturbance for cancer patients showed a significant relationship with Symptom Interference and cancer stage. The significant factors influencing Sleep Disturbance were Symptom Severity and Symptom Interference. They explained 40.5% of the variance in stage IV. CONCLUSION: Patients with cancer experienced Symptom Severity and Symptom Interference which led to a negative effect on Sleep Disturbance. The results suggest that intervention programs to reduce Symptom Severity, Symptom Interference could improve Sleep Disturbance for cancer patients.
Humans ; Korea ; Sleep Wake Disorders ; Weights and Measures

To study the biology of the endothelium and media under conditions that mimic the architecture of the vascular wall and the effects of low density lipoprotein(LDL) and oxidized lipoprotein(ox-LDL), three dimensional vascular wall model was constructed in vitro. In the vascular wall model, endothelial cells(EC) were grown on a collagen lattice containing multilayer of smooth muscle cells(SMC) and endothelial cell-free portion was made by a cloning ring on the culture disc. The availability of this vascular wall model promptly us to examine the extent LDL and ox-LDL affect ECs and SMCs when these cells were maintained with or without each other in coculture. The results were as follows; 1) Morphologic characteristics of three dimensional vascular wall model Artificial vascular wall was a whitish, non-transparent membrane. Outer boundaries and the zone of no ECs were thicker than that of central portion. By light microscope imaging, luminal surface was EC monolayer, and SMCs and collagen fibers were distributed between the PET membrane and EC monolayer. SMCs and collagen fibers were mainly located near the PET membrane. Venous SMCs were densely infiltrated as compared to arterial SMCs. By scanning electron microscopy, EC monolayer was clearly shown. 2) The effects of LDL and oxidized LDL on ECs and SMCs in artificial vascular wall (1) The effects of LDL Collagen fibers are infiltrated just beneath EC monolayer in venous SMCs-EC coculture model. In the zone of no EC, marked proliferation and synthesis of collagen fibers were noted. (2) The effects of ox-LDL Injured EC monolayer were clearly shown in both venous and arterial SMCs-EC coculture model. On high power field light microscopic examination, collagen fibers were exposed outside to the luminal surface and were pendendicularly arranged, and looked like as ciliary projection. Artificial wall of these experimental model were thicker than that of control, and proliferation of SMCs and collagen synthesis were increased than those of control and LDL experiment groups. On scanning electromicroscopic examination, ECs were more slender and cell-to-cell contact was loosened. As a conclusion, this vascular wall model is to be good experimental model for vascular research. And LDL and ox-LDL have toxic effects on vascular EC layer and stimulate proliferation of SMCs and collagen synthesis in vitro three dimensionally constructed vascular wall model.
Biology ; Clone Cells ; Cloning, Organism ; Coculture Techniques ; Collagen ; Endothelial Cells ; Endothelium ; Lipoproteins ; Membranes ; Microscopy, Electron, Scanning ; Models, Theoretical ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Phenobarbital

BACKGROUND: Ischemic stroke is a complex condition influenced by many factors. Previous studies have demonstrated that inflammatory markers might play a role in such vascular diseases. Therefore the purpose of this study was to compare the expression of inflammatory markers in Korean ischemic stroke patients and to investigate their relationship to APOE polymorphism. METHODS: The patient group consisted of 275 patients with large artery atherosclerosis (LAA, n=169) and small artery occlusion (SAO, n=106). One hundred and nineteen age matched healthy subjects were recruited as the control group. Serum levels of three inflammatory markers (matrix metalloproteinase, MMP-9; tissue inhibitor of metalloproteinase-1, TIMP-1; and high-sensitivity C-reactive protein, hs-CRP) were measured in each patient by using commercially available kits. Comparison of clinical risk factors, inflammatory marker levels, and APOE genotypes between the stroke patient group and control group and between the two patient subgroups was assessed. RESULTS: Comparison of the stroke group to control group showed significantly elevated levels of circulating MMP-9 (P<0.01) and hs-CRP (P=0.01). Comparison between the individual subgroups revealed a significantly higher level of only TIMP-1 in the LAA subgroup compared to the SAO subgroup (P<0.01). There was no significant difference in inflammatory marker levels among each allele carrier. CONCLUSIONS: The present study revealed the obvious tendency of increased circulating inflammatory markers in the patients with acute ischemic attack, especially MMP-9 and hs-CRP. Our observations suggest that measurement of serum MMP-9, TIMP-1, and hs-CRP levels may be useful in the diagnosis of ischemic stroke patients.
Aged ; Apolipoproteins E/*genetics ; Biological Markers/blood ; Brain Ischemia/complications/*diagnosis ; C-Reactive Protein/analysis ; Carotid Artery Diseases/complications ; Female ; Genotype ; Humans ; Inflammation Mediators/*blood ; Korea ; Male ; Matrix Metalloproteinase 9/blood ; Middle Aged ; Polymorphism, Genetic ; Stroke/*diagnosis/etiology/immunology ; Tissue Inhibitor of Metalloproteinase-1/blood

BACKGROUND: Fasting has a profound impact on GH synthesis, and is released in all mammalian species that have been studied. The male rat has long been used as a model to determine the mechanism on how fasting mediates these changes. However, many aspects of GH synthesis, release and function are known to be gender-dependent. This study was conducted in order to determine if changes in the GH-axis, in response to fasting, differs between the sexes. METHODS: Male and female rats (8~9 weeks; n=5/group) were fasted for 72h, or supplied food ad libitum. The mean circulating serum GH and IGF-I concentrations were measured by radioimmunoassay. The levels of hypothalamic GH-releasing hormone (GHRH), somatostatin (SRIF), neuropeptide Y (NPY) and pituitary GH mRNA were measured using an RNase protection assay. The levels of pituitary GHRH receptor (GHRH-R), GH secretagogue (GHS) receptor (GHS-R) and SRIF receptor (sst1-5) mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Fasting resulted in a comparable weight loss in both the males and the females, (18.0+/-0.9%) and (17.0 0.8%), respectively. In the fasted males, there was a characteristic decrease in the serum GH (98 60 vs. 7 4 ng/mL) and IGF-I (367 35 vs 152 12 ng/mL), associated with a decrease in the hypothalamic GHRH, and an increase in the NPY mRNA, levels of 52 6% and 138 6%, respectively, compared to those of the fed controls (p<0.05). In spite of the reduction in the GHRH, fasting did not alter the levels of the pituitary GH mRNA, and in fact increased the expression of the pituitary receptors, GHRH-R and GHS-R, to 185 15 and 169 25%, respectively, to those of the fed controls. In contrast to the positive impact of fasting on the GH-stimulatory receptors, fasting led to a dramatic decrease in the expressions of the somatostatin receptor subtypes, sst2 (29+/-5% of Fed) and sst4 (60+/-7% of Fed). Fasting had comparable effects on the GH-axis of the female rats, with two notable exceptions; first, fasting did not suppress the mean circulating GH levels (16 3 vs. 38 28 ng/mL) and second, did not alter the sst2 and sst4 expressions. CONCLUSION: These results corroborate the other reports regarding the effects of fasting on the expressions of hypothalamic neuropeptides, pituitary GHRH-R and sst2, in male rats. This is the first report demonstrating that fasting stimulates the expression of pituitary GHS-R in both sexes. This is of great interest given the fact that ghrelin, the putative GHS-R ligand, is also elevated by fasting. We propose that the upregulation of both ghrelin and GHS-R may play important roles in increasing the sensitivity of the pituitary to GHRH, in that these GH-stimulatory systems work synergistically. These changes may compensate for the fasting-induced suppression of hypothalamic GHRH input. We might speculate that such compensatory mechanisms are dominant in the female rat, in that circulating GH levels are not suppressed by fasting.
Animals ; Axis, Cervical Vertebra* ; Fasting* ; Female* ; Ghrelin ; Growth Hormone ; Humans ; Hypothalamus ; Insulin-Like Growth Factor I ; Male* ; Neuropeptide Y ; Neuropeptides ; Radioimmunoassay ; Rats* ; Receptors, Somatostatin ; Ribonucleases ; RNA, Messenger ; Somatostatin ; Up-Regulation ; Weight Loss

In order to observe the effects of serum albumin and fibrinogen on biophysical surface properties and the morphology of pulmonary surfactant in vitro, we measured the surface adsorption rate, dynamic minimum and maximum surface tension (min-, max-ST) by Pulsating Bubble Surfactometer, and demonstrated ultrastructures on a series of mixtures with varying concentrations of albumin or fibrinogen and Surfactant-TA. The albumin and fibrinogen significantly inhibited the adsorption rate and ST-lowering properties of surfactant through increasing STs of adsorption rate, min-ST, and max-ST. The characteristic morphology of the Surfactant-TA changed from lamellar rod-like structure with open ends into spherical structures with loss of their open ends by mixing with albumin or fibrinogen. These inhibitory effects of albumin and fibrinogen on surface properties of surfactant were dependent upon the increasing concentration of albumin or fibrinogen. We concluded that albumin and fibrinogen significantly altered surfactant function and its ultrastructural morphology in vitro. These findings support the concept that albumin and fibrinogen-induced surfactant dysfunction may play an important role in the pathophysiology of adult respiratory distress syndrome, and this adverse effect of albumin and fibrinogen on surfactant might be overcome by administration of large doses of exogenous surfactant.
Adsorption ; Animal ; Cattle ; Fibrinogen/pharmacology* ; Human ; Pulmonary Surfactants/ultrastructure* ; Pulmonary Surfactants/drug effects ; Serum Albumin, Bovine/pharmacology* ; Surface Properties

CONTEXT: The Internet is increasingly used by consumers to seek health and medical information, but online medical consultation has not been explored systematically. OBJECTIVE: To analyze Questions and Answers in Internet Based Medical Consultation in Oriental Traditional Medicine and to provide what is the need for this area. SUBJECTS AND METHOD: 1188 Dialogues of 96 consutant O.M.D(Oriental Medical Doctor) on 6 Web sites which is analyzed through frequency, correlation and ANOVA RESULTS AND CONCLUSIONS: First, Amount of Answer is small(290 characters). Responding time is long. And Numbers per consultant O.M.D is small. So Service Provider need to develope 'Supporting Tool for Writing Answer' . Secondly, User asked of home therapy and everyday discomfort, but Consultant didn t suggest appropriate answers. Thirdly, About 30% of total questions was inappropriate. 'Supporting Tool for Questioning' could decrease the ratio of inappropriate questions.
Consultants ; Humans ; Internet* ; Medicine, East Asian Traditional* ; Needs Assessment ; Remote Consultation ; Writing

PURPOSE: Meager research has been carried out to determine the effectiveness of the token economy among patients behaving violently in mental hospitals. The purpose of this study was to examine the effectiveness of the Short-Term Token Economy (STTE) on violent behavior among chronic psychiatric in-patients. METHODS: A nonequivalent control group design method was utilized. Participants in an experimental group (n=22) and control group (n=22) took part in this study from January to April, 2008. Observation on aggressive behavior among male in-patients in one hospital as a baseline was made during the week before the behavior modification program and measurement of aggressive behavior was done using the Overt Aggression Scale (OAS), which includes verbal attacks, property damage and physical attacks. RESULTS: The aggressive behavior scores of the experimental group decreased, those of the control group, scores showed an increase after the eight-week behavior modification program utilizing STTE. CONCLUSION: The results of the study indicate that STTE is effective in reducing the incidence of aggressive behavior among male in-patients in psychiatric hospitals. The outcome of this study should be helpful in reducing the use of coercive measures or psychoactive medication in controlling the violent behavior among in-patients in hospitals.
Adult ; Aggression ; *Behavior Therapy ; Hospitals, Psychiatric ; Humans ; Male ; Mental Disorders/psychology/*therapy ; Middle Aged ; Program Evaluation ; *Token Economy ; Violence

OBJECTIVE: The objective of this research is to survey the requirements of Oriental Medical Informatics, and to suggest a direction that Oriental Medical Informatics development may take. METHODS: Consumers and medical experts were randomly selected, and 14 uestions for consumers and 17 questions for medical experts were sent to respondents by mail and e-mail. RESULTS: Both consumers and medical experts were greatly concerned with the systemized dissemination of Oriental Medical Information, but they were not satisfied with it because of the perceived low quality of the information. Medical experts responded that they need standards and statistical evidences for Oriental Medicine. Consumers demanded good-quality information about diseases and health management. CONCLUSION: To carry out Oriental Medical Informatics, it is necessary to conduct a joint research between the sectors of Oriental Medicine and Information Technology, followed by the development of a standard information infrastructure. Oriental Medicine must also have standards in terms of medical data content, data format, and data communication, to ensure the reliability of the disseminated information on Oriental Medicine.
Surveys and Questionnaires ; Electronic Mail ; Joints ; Medical Informatics ; Medicine, East Asian Traditional* ; Postal Service

BACKGROUND & PURPOSE: Fibrinoeptide-A (FpA) and D-dimer have been well known as hematologic parameters for activation of the coagulation and the endogeneous fibrinolysis system during acute phase of ischemic stroke. We measured the levels of FpA and D-dimer in acute progressive and non-progressive ischemic strokes to assess whether these markers are valuable as a predictor of stroke progression during acute phase. METHODS: FpA (RIA method) and D dimer (ELISA method) were determined in 54 patients, 9 with acute progressive and 45 with non-progressive within acute stage(< 48 hours of onset) of cerebral infarction. RESULTS: Levels of FpA in patients with acute progressive stroke were significantly higher than those in patients with non-progressive stroke, indicating activation of the coagulation system (P = 0.013). And, levels of D-dimer in patients with acute progressive stroke were also higher than those in patients with non-progressive stroke but statistically insignificant(P-0.071). CONCLUSIONS: These findings suggest that the coagulation system is more enhanced in progressive stroke than non-progressive one during acute stage of ischemic stroke. Higher levels of FpA are thought to be useful markers to predict stroke in progression.
Cerebral Infarction ; Fibrinolysis ; Humans ; Stroke*