BACKGROUND AND OBJECTIVES: Nitric oxide (NO) reduces the intracellular Ca2+ concentration ([Ca2+]i) in smooth muscle cells, whereas the effect of NO on [Ca2+]i in endothelial cells is still controversial. Therefore, the effect of NO on the [Ca2+]i, and its mechanism in mouse aortic endothelial cells (MAEC) and human umbilical vein endothelial cells (HUVEC) were examined. MATERIALS AND METHODS: In primary cultured MAEC and HUVEC, cells were loaded with fura 2-AM and [Ca2+]i and measured using a microfluorometer. RESULTS: The NO donor, sodium nitroprusside (SNP), reduced the [Ca2+]i in 72% of the cells tested (n=100). In the remaining cells, the effect of SNP was biphasic, or the [Ca2+]i was increased. In addition, the membrane-permeable cGMP, 8-bromo cGMP, decreased the [Ca2+]i. The effects of SNP and 8-bromo cGMP were inhibited by the soluble guanylate cyclase inhibitor, 1H-[1,2,4] oxadiazole[4,3-a]quinoxalin-1-one (ODQ), and the cGMP-dependent protein kinase inhibitor, KT5823, respectively. In contrast, in the presence of 8-bromo cGMP or ODQ, SNP increased the [Ca2+]i. CONCLUSION: These results suggest that NO inhibits the [Ca2+]i through a cGMP-dependent mechanism and increases the [Ca2+]i through a cGMP-independent mechanism.
Animals ; Cyclic GMP ; Endothelial Cells* ; Endothelium ; Guanylate Cyclase ; Human Umbilical Vein Endothelial Cells ; Humans ; Mice ; Myocytes, Smooth Muscle ; Nitric Oxide ; Nitroprusside ; Protein Kinases ; Tissue Donors

The purpose of this study was to investigate the relationship between stress and oral symptoms, and quality of life in university students. This survey was performed on 452 university students in the Daejeon area. The research was conducted during 2 weeks in June 2016 using a self-reported questionnaire. The data were analyzed by PASW Statistics ver. 18.0. According to the findings of the study, higher levels of stress were detected in girls than in boys (p<0.05). Stress had a significant impact on the symptoms of dry mouth, bad breath, and temporomandibular pain (p<0.05). The high-stress group experienced a negative impact on oral impacts on daily performance (OIDP) scores as compared to the group with lower stress. Stress had a significantly positive correlation with dry mouth, bad breath, temporomandibular joint (TMJ). OIDP was a significant positive correlation with dry mouth, bad breath, TMJ and stress. The findings of the study showed that stress exerted a significant influence on the oral symptoms and quality of life in university student.
Female ; Humans ; Mouth ; Oral Health* ; Quality of Life* ; Temporomandibular Joint

Primary fetal hydrothorax presents a wide spectrum of severity ranging from small harmless effusions to life-threatening thoracic compression. Management of this condition is controversial. We experienced a case of non-chylous primary fetal hydrothorax not associated with hydrops or other malformations. A predominantly unilateral hydrothorax in a fetus was diagnosed by sonography at 31 weeks gestation. Repeated ultrasonographic examinations to detect development of hydrops or progression of intrapleural effusion were used to evaluate the need for intrauterine thoracentesis and to decide the optimal time for delivery. Two thoracenteses were performed. The baby was delivered at 34 weeks. Postnatal intubation was carried out in the baby, and then chest tube placement was performed and resulted in the collection of 805ml of serous fluid. Sustained intubation was necessary for 16 days because of developing respiratory distress as a result of prematurity and recurrent pleural fluid accumulation. The baby did well after postnatal evacuation of the intrapleural fluid. Pre and postnatal investigation to find the pathophysiological mechanism leading to hydrothorax were negative. We conclude that non-chylous primary fetal hydrothorax is generally associated with a favorable outcome.
Chest Tubes ; Edema ; Fetus ; Hydrothorax ; Intubation ; Pregnancy

Visual disturbances are common among women with pre-eclampsia. The obstetricians should have an understanding of the various conditions associated with visual impairments. We report a case of Purtscher-like retinopathy developed after pre-eclampsia combined with acute pancreatitis. A 33-year-old primigravida with twin pregnancy was admitted to the department of obstetrics and gynecology for preterm labor and pre-eclampsia at 36+4 weeks gestation. After a cesarean section, she complained of abdominal pain and visual acuity loss. She was diagnosed with Purtscher-like retinopathy combined with acute pancreatitis after ophthalmologic examination and an abdominal computed tomography scan. Purtscher-like retinopathy, most often observed after trauma, is very rare in pre-eclampsia. In addition, while visual disturbances from other conditions are transient, it can result in persistent visual impairments. Thus, when a patient with pre-eclampsia complains of visual problems for a long period of time, obstetricians should consider an ophthalmologic evaluation and treatments during the earliest stage of the disease.
Abdominal Pain ; Cesarean Section ; Female ; Gynecology ; Humans ; Obstetric Labor, Premature ; Obstetrics ; Pancreatitis ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Twin ; Retinal Diseases ; Vision Disorders ; Visual Acuity

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.
Hospitals, General ; Humans ; Job Satisfaction ; Nurse Clinicians ; Nurse Practitioners ; Nursing ; Patient Selection ; Physician Assistants ; Prescriptions

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of diverse autoantibodies with various systemic organ involvements. In patients with SLE, autoantibodies, such as antinuclear antibody (ANA) and anti-dsDNA antibody, play an important role not only in diagnosing the disease, but also representing the pathogenesis of the disease. ANA is the main screening tool in diagnosis and serum complement levels and anti-dsDNA antibody level are closely related to the disease activities. Nevertheless, exceptionally, some patients represent with negative ANA and/or anti-dsDNA antibody leading to difficulties in diagnosing the disease. Here, we report a case of 37-year old female SLE patient with negative ANA, negative anti-dsDNA antibody, and positive anti-Ro/SSA antibody, which manifested with nephrotic syndrome.
Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Complement System Proteins ; Female ; Glomerulonephritis, Membranous ; Humans ; Lupus Erythematosus, Systemic ; Mass Screening ; Nephrotic Syndrome

OBJECTIVE: To determine the factors associated with unmet needs in immigrant patients complaining of abdominal pain, by analyzing those associated with the time from symptom onset to emergency room visit.METHODS: We retrospectively reviewed the medical records of immigrants with abdominal pain who visited a tertiary hospital emergency department from January to December 2016. The dependent variable was the time from symptom onset to emergency room visit. The independent variables were age, sex, vital signs, disposition, health insurance status, date of visit, time of visit, level of education, employment status, economic satisfaction, marital status, living with family, duration of residence, having a native spouse, and subjective proficiency in Korean. We analyzed the association of the dependent variable with each independent variable.RESULTS: In total, 102 immigrant patients with abdominal pain were enrolled in this study. The patients who had earlier visits had good subjective proficiency in Korean, high economic satisfaction, longer durations of residence, a tendency to have a native spouse, and a high employment rate. After linear regression analysis, the time from symptom onset to emergency room visit was negatively associated with employment (adjusted odds ratio, -13.67; 95% confidence interval, -23.25 to -4.09; P=0.006) and having a native spouse (adjusted odds ratio, -11.7; 95% confidence interval, -20.61 to -2.8; P=0.011).CONCLUSION: The factors influencing the time from symptom onset to emergency room visit in immigrant patients with abdominal pain are associated with social capital, which improves access to emergency care. Policies that improve immigrant access to emergency care should be considered.
Abdominal Pain ; Adult ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Emigrants and Immigrants ; Employment ; Health Services Needs and Demand ; Humans ; Insurance, Health ; Korea ; Linear Models ; Marital Status ; Medical Records ; Odds Ratio ; Retrospective Studies ; Social Capital ; Spouses ; Tertiary Care Centers ; Vital Signs

Glucokinase is expressed only in both liver and pancreatic beta cells and has a key role in the regulation of glucose metabolism in these tissues. A number of gene defects associated with glucokinase gene and the cause of non-insulin-dependent diabetes mellitus are known, and the defects along the -30bp promoter site in particular are thought to be related to diabetes and glucose intolerance. To research on gene study related to diabetes, we looked into the relationship between the variation at -30bp of pancreatic beta cell specific glucokinase gene promoter and gestational diabetes mellitus(GDM) in Korea. METHODS: Forty patients with GDM and 62 normal controls were studied. Genomic DNA was extracted from peripheral leukocyte of patients with GDM and normal controls. The nucleotide variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter was analyzed by PCR-SSCP methods. The sequences of amplified DNA were confirmed with direct sequencing method. The clinical features and the response of insulin secretion to oral glucose were analyzed between patients with GDM according to genotypes. RESULTS: Allelic frequency of position -30 bp of pancreatic beta cell specific glucokinase gene promoter did not differ between patients with GDM and normal subjects. However the frequency of G/A and A/A genotypes seemed to show a higher tendency in patients with GDM compare to the normal subjects. Clinical features, insulin response to oral glucose did not differ according to the type of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter. CONCLUSION: These data suggested that the variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter in patients with GDM are unlikely to be one of the possibilities of the genetic factors in the development of GDM. Therefore more sophisticated studies will be needed to elucidate the role of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter in the insulin secretion to oral glucose.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; DNA ; Female ; Genotype ; Glucokinase* ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Insulin-Secreting Cells ; Korea ; Leukocytes ; Liver ; Metabolism ; Pregnancy

Glucokinase is expressed only in both liver and pancreatic beta cells and has a key role in the regulation of glucose metabolism in these tissues. A number of gene defects associated with glucokinase gene and the cause of non-insulin-dependent diabetes mellitus are known, and the defects along the -30bp promoter site in particular are thought to be related to diabetes and glucose intolerance. To research on gene study related to diabetes, we looked into the relationship between the variation at -30bp of pancreatic beta cell specific glucokinase gene promoter and gestational diabetes mellitus(GDM) in Korea. METHODS: Forty patients with GDM and 62 normal controls were studied. Genomic DNA was extracted from peripheral leukocyte of patients with GDM and normal controls. The nucleotide variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter was analyzed by PCR-SSCP methods. The sequences of amplified DNA were confirmed with direct sequencing method. The clinical features and the response of insulin secretion to oral glucose were analyzed between patients with GDM according to genotypes. RESULTS: Allelic frequency of position -30 bp of pancreatic beta cell specific glucokinase gene promoter did not differ between patients with GDM and normal subjects. However the frequency of G/A and A/A genotypes seemed to show a higher tendency in patients with GDM compare to the normal subjects. Clinical features, insulin response to oral glucose did not differ according to the type of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter. CONCLUSION: These data suggested that the variation at -30 bp of pancreatic beta cell specific glucokinase gene promoter in patients with GDM are unlikely to be one of the possibilities of the genetic factors in the development of GDM. Therefore more sophisticated studies will be needed to elucidate the role of variation at -30bp of pancreatic beta cell specific glucokinase gene promoter in the insulin secretion to oral glucose.
Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; DNA ; Female ; Genotype ; Glucokinase* ; Glucose ; Glucose Intolerance ; Humans ; Insulin ; Insulin-Secreting Cells ; Korea ; Leukocytes ; Liver ; Metabolism ; Pregnancy