PURPOSE: TGF-beta is a key regulator of epithelial-mesenchymal transition. Among the TGF-beta responses, cell migration is closely associated with the expression of matrix metalloproteinases (MMPs). Therefore, we determined which MMPs are regulated by TGF-beta and examined the TGF-beta signaling involved in this event, focusing on Src family tyrosine kinases (SFKs) METHODS: First we examined the expression of MMPs in rat lens explant culture treated with TGF-beta and LECs attached to the anterior capsules of patients with nuclear (N), anterior polar (AP) cataracts using RT-PCR and immunofluorescence staining. It was examined whether the expression of MMPs is regulated by SFKs. RESULTS: The study using RT-PCR and immunofluorescence staining showed the expression of MMP-2 and -14 in explants and the expression of MMP-14 LECs of AP cataracts. The expression of MMP-2 and -14 was blocked by PP2 in explants. Furthermore, the activated form of SFKs was observed in LECs of AP cataracts by immunofluorescence staining. CONCLUSIONS: We suggest a novel role of SFKs signaling in the expression of MMP-14 induced by TGF-beta.
Animals ; Capsules ; Cataract ; Cell Movement ; Epithelial Cells* ; Epithelial-Mesenchymal Transition ; Fluorescent Antibody Technique ; Humans ; Matrix Metalloproteinases ; Rats ; src-Family Kinases ; Transforming Growth Factor beta*

Purpose: The purpose of this study is to identify and prioritize educational needs for psychiatric nursing competencies among 142 non-psychiatric nurses from general hospitals. Methods: Data were collected from November 13 to 19 2022 through self-administered questionnaires consisting of measures of psychiatric nursing competencies. Data were analyzed using descriptive statistics, paired t-test, Borich's needs assessment model, and the Locus for Focus model to determine the priority of educational needs. Results: Non-psychiatric nurses reported that enhancing skills in psychiatric nursing were more significant than improving knowledge and attitude using Borich’s Needs Assessment Model and the Locus for Focus Model. The highest priority educational needs were ‘Skill to distinguish whether symptoms in psychiatric patients are symptoms of mental illness or side effects of psychiatric drugs’, ‘Skill to calm and supportive communication in psychiatric emergency when psychiatric patients are at risk of harm’, ‘Attitude to remain calm about the psychotic behaviors of psychiatric patients’, and ‘Knowledge of non-therapeutic communication that interferes with effective communication with psychiatric patients’. These items should be considered as priorities among the 39 items to improve psychiatric nursing competencies. Conclusion Results of this study suggest that developing intervention programs to enhance psychiatric nursing competencies are needed among non-psychiatric Nurses.

BACKGROUND: It has been reported that the association between blood pressure and cognitive impairment could be modified by factors such as gender, education, and Apo E genotypes. This study was aimed to investigate whether `age' could also be a modifier of the association. METHODS: The study group consisted of 489 participants aged 65 years or over who lived in Namwon, Korea. The presence of hypertension was ascertained by the measurement of their resting blood pressure. A cognitive impairment was considered to be present when a Korean Mini-Mental State Examination score was less than 19 (30th percentile). RESULTS: A higher systolic blood pressure was significantly associated with cognitive impairment, after an adjustment for age, gender, education, and occupation. However, the significance was lost in subjects aged 71 or over. CONCLUSIONS: High systolic blood pressure is a factor strongly associated with cognitive impairment in an aged population. However, in the subjects with far advanced age, the association is not significant. Further studies are required to elucidate whether blood pressure lowering strategies should be differentiated according to age in order to reduce cognitive impairment.
Adult* ; Aged* ; Apolipoproteins E ; Blood Pressure* ; Education ; Genotype ; Humans ; Hypertension ; Jeollabuk-do ; Korea ; Occupations

A male patient aged 54 came to the neurology department complaining of weakness and tingling sensation in the left lower extremity during squatting exercises for the previous four days. A neurological examination revealed left proximal leg weakness and hypesthesia on the medial side of the left lower leg. In eight hours after onset, he took brain and lumbar MRIs at a local clinic and the results were normal. In order to identify possible causes, we performed a follow-up lumbar MRI, femoral angiography, electromyography, and nerve conduction study but failed to obtain any abnormal findings. Finally, a recent infarction of right corona radiata was observed by a follow-up brain MRI which was taken 16 days after onset of the symptom. Leg monoparesis caused by cerebral infarction is known to be rare and in particular combines motor and sensory deficits limited to one extremity.
Aged ; Angiography ; Brain ; Cerebral Infarction ; Electromyography ; Exercise ; Extremities ; Follow-Up Studies ; Humans ; Hypesthesia ; Infarction ; Leg ; Lower Extremity ; Male ; Neural Conduction ; Neurologic Examination ; Neurology ; Paresis ; Porphyrins ; Sensation

Nutcracker syndrome (NCS) is a disease caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Immunoglobulin A (IgA) nephropathy (IgAN) is characterized by the predominance of IgA deposits in the glomerular mesangial area. Hematuria and proteinuria can be present in both diseases, and some patients can be concurrently diagnosed with NCS and IgAN; however, a causal relationship between the two diseases has not yet been clarified. Here, we report two pediatric cases of NCS combined with IgAN. The first patient presenting with microscopic hematuria and proteinuria was diagnosed with NCS at the initial visit, and the second patient was later diagnosed with NCS when proteinuria worsened. Both patients were diagnosed with IgAN based on kidney biopsy findings and treated with angiotensin-converting enzyme inhibitors and immunosuppressants. A high index of suspicion and timely imaging or biopsy are essential for the proper management of NCS combined with glomerulopathy.

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.
Arteries ; Audiometry ; Basilar Artery ; Brain ; Cerebral Infarction ; Deafness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Otoscopy ; Vertebrobasilar Insufficiency

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.
Arteries ; Audiometry ; Basilar Artery ; Brain ; Cerebral Infarction ; Deafness ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Magnetics ; Magnets ; Otoscopy ; Vertebrobasilar Insufficiency

OBJECTIVE: Ovarian cancer represents a relatively chemosensitive solid tumor, with responsiveness to a range of agents. Cisplatin is the mainstay of drug treatment and is one of the most active single agent. However, the overall outcome for patients remains unsatisfactory and the emergence of drug resistance is a major factor in treatment failure. Loss of DNA mismatch repair is a common finding in many types of sporadic cancer as well as in patients with hereditary nonpolyposis colon cancer. Cells that lack DNA mismatch repair are resistant to commonly used chemotherapeutic agents. Selection of cells for resistance to cisplatin, a well-recognized mutagen, could result in mutation in genes involved in DNA mismatch repair. METHODS: This study evaluated the mutation of hMLH1 and hMSH2, and its relation to the Taxol and Topotecan chemosensitivity in the clones from the ovarian cancer cell line 2008 and cisplatin-resistant cell line 2008/ C13*5.25. RESULTS: 1. Cells from 2008 and 2008/C13*5.25 expressed both hMLH1 and hMSH2 when analysed with immunoblotting. 2. Twenty two out of 100 single-cell clones from 2008 and 27 of clones from 2008/C13*5.25 expressed no hMLH1. hMSH2 was expressed in all clones. 3. There was no difference of Taxol chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1-deficient clones were more sensitive to Taxol than the hMLH1-proficient clones(P=0.049), but in 2008 cell lines hMLH1-proficient clones were more sesitive to Taxol(P=0.003). 4. There was no difference in Topotecan chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1- deficient clones were not more sensitive to Topotecan than the hMLH1-proficient clones. In the 2008 cell lines hMLH1-deficient clones were more sesitive to Topotecan(P=0.001). Overall, hMLH1-deficient clones from both 2008 and 2008/C13*5.25 cell lines were significantly more sensitive to Topotecan(P=0.001). 5. Microsatellite instability was not demonstrated in all 4 types of single-cell clones from 2008 and 2008/C13*5.25 cell lines. CONCLUSIONS: The present results indicate that there is no relation between mutation of mismatch repair gene and cisplatin resistance. But hMLH1-deficient ovarian cancer cells are more sensitive to Taxol or Topotecan in this study. The latter finding mandates the examination to assess the mutation of hMLH1 in tumor cells before treatment or at the time clinical resistance to cisplatin develops in ovarian cancer.
Cell Line* ; Cisplatin ; Clone Cells* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair* ; DNA* ; Drug Resistance ; Humans ; Immunoblotting ; Microsatellite Instability ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan* ; Treatment Failure

Cryptococcosis is recognized as one of the most important complications in an organ transplant recipient. Cryptococcosis occurs in 2.5-39% of renal transplant recipients. This infection generally presents as symptomatic disseminated disease with an accelerated clinical course, involves multiple sites including the central nervous system, lungs, and skin. And if diagnosis or treatment is delayed, the prognosis is generally poor. The asymptomatic infection is rare and there are no case reports of asymptomatic disseminated cryptococcosis after renal transplantation in Korea. We experienced a case of asymptomatic cryptococcal multi-organ infection detected incidentally in a 51-year-old male received a living related renal transplant 35 months earlier for end-stage renal disease due to diabetic nephropathy. We treated successfully with amphotericin B and fluconazole and hereby report this case with a review of the relevant literature.
Amphotericin B ; Asymptomatic Infections ; Central Nervous System ; Cryptococcosis ; Diabetic Nephropathies ; Fluconazole ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Korea ; Lung ; Male ; Middle Aged ; Prognosis ; Skin ; Transplants

BACKGROUND: The detection of collapsible airways has important therapeutic implications in chronic airway disease and bronchial asthma. The distinction of a purely collapsible airways disease from that of asthma is important because the treatment of the former may include the use of pursed lip breathing or nasal positive pressure ventilation whereas in the latter, pharmacologic approaches are used. One form of irreversible airflow limitation is collapsible airways, which has been shown to be a component of asthma or to emphysema, it can be assessed by the volume difference between what exits the lung as determined by a spirometer and the volume compressed as measured by the plethysmography. METHOD: To investigate whether volume difference between slow and forced vital capacity(SVC-FVC) by spirometry may be used as a surrogate index of airway collapse, we examined pulmonary function parameters before and after bronchodilator agent inhalation by spirometry and body plethysmography in 20 cases of patients with evidence of airflow limitation(chronic obstructive pulmonary disease 12 cases, stable bronchial asthma 7 cases, combined chronic obstructive pulmonary disease with asthma 1 case) and 20 cases of normal subjects without evidence of airflow limitation referred to the Pusan National University Hospital pulmonary function laboratory from January 1995 to July 1995 prospectively. RESULTS: 1) Average and standard deviation of age, height, weight of patients with airflow limitation was 58.3+/-7.24(yr), 166+/-8.0(cm), 59.0+/-9.9(kg) and those of normal subjects was 56.3+/-12.47(yr), 165.9+/-6.9(cm), 64.4+/-10.4(kg), respectively. The differences of physical characteristics of both group were not significant statistically and male to female ratio was 14:6 in both groups. 2) The difference between slow vital capacity and forced vital capacity was 395+/-317ml in patients group and 154+/-176ml in normal group and there was statistically significance between two groups(p<0.05). Sensitivity and specificity were most higher when the cut-off value was 208ml. 3) After bronchodilator inhalation, reversible airway obstructions were shown in 16 cases of patients group, 7 cases of control group(p<0.05) by spirometry or body plethysmography and the differences of slow vital capacity and forced vital capacity in bronchodilator response group and nonresponse group were 300.4+/-306ml, 144.7+/- 180ml and this difference was statistically significant. 4) The difference between slow vital capacity and forced vital capacity before bronchodilator inhalation was correlated with airway resistance before bronchodilator(r=0.307 p=0.05), and the difference between slow vital capacity and forced vital capacity after bronchodilator was correlated with difference between slow vital capacity and forced vital capacity(r=0.559 p=0.0002), thracic gas volume(r=0.488 p=0.002) before bronchodilator and airway resistance(r=0.583 p=0.0001), thoracic gas volume(r=0.375 p=0.0170) after bronchodilator, respectively. 5) The difference between slow vital capacity and forced vital capacity in smokers and nonsmokers was 267.5+/-303ml, 277.5+/-276ml, respectively and this difference did not reach statistical significance(p>0.05). CONCLUSION: The difference between slow vital capacity and forced vital capacity by spirometry may be useful for the detection of collapsible airway and may help decision making of therapeutic plans.
Airway Obstruction ; Airway Resistance ; Asthma ; Bronchodilator Agents ; Busan ; Decision Making ; Emphysema ; Female ; Humans ; Inhalation ; Lip ; Lung ; Lung Diseases, Obstructive ; Male ; Plethysmography ; Positive-Pressure Respiration ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Respiration ; Sensitivity and Specificity ; Spirometry ; Vital Capacity