No abstract available.
Arm* ; Chromosomes, Human, Pair 14*

BACKGROUND: Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occured.
Airway Obstruction ; Bronchi ; Bronchoscopes ; Bronchoscopy ; Catheters ; Fibrinolytic Agents ; Hemoptysis ; Humans ; Korea ; Middle Aged ; Streptokinase ; Suction ; Superior Vena Cava Syndrome ; Surgical Instruments ; Therapeutic Irrigation ; Urokinase-Type Plasminogen Activator*

PURPOSE: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). METHODS: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. RESULTS: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR chi2=44.56, P=0.001; AD chi2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (chi2=7.41, P=0.0025). CONCLUSION: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.
Advance Directive Adherence ; Advance Directives ; Caregivers* ; Decision Making ; Employment ; Hospice Care ; Hospitals, General ; Humans ; Medical Staff* ; Personnel, Hospital ; Resuscitation Orders ; Surveys and Questionnaires

The present study was aimed at investigating the effect of cyclosporine A (CsA) on the renal renin-angiotensin systems. In rats chronically treated with CsA, the intrarenal expression of various genes of the renin-angiotensin system was assessed by Northern blot analysis. Along with the increases in plasma and renal renin activities, chronic CsA-treatment differentially affected the renal expression of renin-angiotensin system. The treatment with CsA for one week did not significantly alter the expression of either type 1 angiotensin II receptor (AT1A) or angiotensinogen gene, but increased the renin mRNA level. The three-week-treatment caused increases in the expression not only of renin but also of AT1A and angiotensinogen genes. Supplementation with L-arginine kept the expression of renin mRNA normal in the one-week-treated, but failed to prevent the alterations of the gene expression in the three-week-treated. Feedback control among components of the renin-angiotensin system also influences angiotesinogen. In the liver, the expression of angiotensinogen mRNA was decreased by the CsA-treatment for either one- or three-weeks. In conclusion, chronic CsA-treatment is associated with a differential expression of various genes for the renin-angiotensin system. L-Arginine may be effective in maintaining the normality of renin-angiotensin system only during early period after beginning the use of CsA.
Angiotensinogen ; Animals ; Arginine ; Blotting, Northern ; Cyclosporine* ; Gene Expression ; Liver ; Plasma ; Rats ; Receptors, Angiotensin ; Renin ; Renin-Angiotensin System* ; RNA, Messenger

The purpose of this study was to examine the effects of 6-wk low intensity exercise program on fatigue, perceived health state, exercise-related affect, perceived benefits, and exercise self-efficacy for female college student's. The subjects of the study consisted of thirty-four female college students. The research subjects were assigned to experimental and control group. The experimental group participated in 13-17 and 30-60 minute sesseions of exercise program over 6 weeks. Data analysis was done by t-test with SAS program. The results of this study are as follows. 1) The first hypothesis, "The fatigue of experimental group will be lower than control group", was supported. 2) The second hypothesis, "The perceived health state of experimental group will be higher than control group", was not supported. 3) The third hypothesis, "The exercise-related affect of experimental group will be higher than control group", was not supported. 4) The fourth hypothesis, "The benefits of exercise of experimental group will be higher than control group", was not supported. 5) The fifth hypothesis, "The self-efficacy for exercise of experimental group will be higher than control group", was supported.
Fatigue* ; Female* ; Humans ; Research Subjects ; Statistics as Topic

In the binary of gender, women and femininity came to be associated with motherhood, nurturing, and beauty whilst men and masculinity were associated with productivity, protection, and strength. No longer are we to systematically categorize an individual's gender in terms of polar opposite of femininity and masculinity, but instead we must acknowledge all that resides in between those two poles and allow for identity terms that best express their sense of self. The term ‘transgender has become an umbrella term for a broader and more encompassing array of gender narratives outside of the binary norm of gender. Gender dysphoria is managed and treatable through psychotherapy and through the social and medical transition of gender. The support of transgender individuals' preferred gender through social acknowledgment, gender expression, hormone therapy, and surgery has been proven to alleviate symptoms of gender dysphoria in transgender people, enabling them to incorporate back into society.
Beauty ; Efficiency ; Female ; Femininity ; Gender Dysphoria ; Gender Identity ; Humans ; Male ; Masculinity ; Psychotherapy ; Transgender Persons*

PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.
Community Health Centers ; Community Health Nursing ; Community Health Services ; Cooperative Behavior ; Delivery of Health Care ; Health Resources ; Hospice Care ; Hospices ; Humans ; Models, Organizational ; Optic Disk ; Organization and Administration ; Pilot Projects

The septum formation(web) of bile duct is an uncommon disease. Its rarity and vague symptoms result in delayed diagnosis. However, the increased use of endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic cholangiography(PTC) have resulted in greater awareness of this entity and understanding of its natural history as well as an increased frequency of diagnosis. We have experienced 4 cases of common bile duct web, which were associated with stones in the bile duct, confirmed by operation.
Bile Ducts ; Common Bile Duct* ; Delayed Diagnosis ; Diagnosis ; Natural History

PURPOSE: To evaluate the effects of dexamethasone(D) on blood pressure(BP) in infants with bronchopulmonary dysplasia(BPD). METHODS: We retrospectively reviewed 10 infants with BPD(mean birth weight: 1,383+/-17 gm, mean gestational age: 29.0+/-1.7 weeks) treated with D at Wonkwang University Hospital from January 1994 to June 1998. D was started at 0.5 mg/kg/day intravenously for first week, followed by 0.3 and 0.1 mg/kg/day for second and third week, respectively. Changes in BP during pre-D, 1st wk(D1), 2ndwk(D2), 3rd wk(D3), and post-D periods were compared using Turkey Kramer multiple comparison test. RESULTS: Mean systolic pressure(sBP) significantly increased in Dl, D2, D3 compared to pre-D(63+1.3, P<0.01; 66+1.7, P<0.001; 683.4, P<0.001 vs 591.9 mmHg, respectively) but significantly decreased in post-D compared to D3(64+/-2.4 mmHg, P<0.05). Mean diastolic pressure(dBP) significantly increased in D2 and D3 compared to pre-D(42+/-1.1, P<0.001; 43+/-2.6, P<0.001, vs 382.1 mmHg, respectively). Mean dBP deed slightly in post-D(41+/-4.1 mrnHg, P>0.05). The sBP and dBP significantly increased from day 2 after initiation of D and were highest on day 17 and 17-18 of 3rd week, respectively. The number of hypertensive infants who were considered for antihypertensive medications were 2(20%) for sBP >or= 80-90 mmHg, 3(30%) for dBP >or= 50 mmHg and 1(10%) for dBP> or =60 mmHg. These infants, however, remained asymptomatic. CONCLUSION: Significant elevation of BP was observed during dexamethasone therapy for infants with BPD especially after 2nd day. However, BP elevation was transient, not requiring antihypertensive medications.
Birth Weight ; Blood Pressure* ; Bronchopulmonary Dysplasia* ; Dexamethasone* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Retrospective Studies ; Turkey

Porcelain is considered to be one of the materials of choice for restoration where esthetics is of concern. But porcelain surface without final glazing treatment may induce undesirable results such as inflammatory respones on adjacent soft tissues due to plaque accumulation and increased wear of opposing teeth. Therefore, rough porcelain surface must be smoothened by final glazing treatment or chairside polishing procedure. The purpose of this study was to compare the surface roughness among self-glazed, overglazed and polished porcelain with various polishing kit, and to detect which phase of polishing is optimal in clinic. Specimens were fabricated with Vita VMK porcelain. The surface treatment of each group was performed as follows. Group 1 : overglazing treatment Group 2 : self-glazing treatment Group 3 : polishing with the Truluster Polishing System for Porcelain(Brasseler, U.S.A.) Group 4 : polishing with the Exa Cerapol Adjustment kit (Edenta dental products, Switzerland) followed by finishing with diamond-filled polishing paste Group 5 : polishing with the Shofu Porcelain Adjustment kit (Shofu inc., Japan) followed by finishing with diamond-filled polishing paste. At each polishing steps, the measurement of Ra and Rq values were performed, and the surface was examined by scanning electron microscope. The results were as follows: 1. Overglazing treatment brought smoother surface than self-glazing treatment. 2. Polishing systems without porcelain polishing paste did not make better result than self-glazing treatment. 3. Polishing system with porcelain polishing paste made similar result to overglazing treatment. 4. Applying diamond-filled polishing paste after using polishing system which has porcelain polishing paste produced surface as smooth as overglazing treatment does.
Dental Porcelain* ; Esthetics ; Tooth