Amniotic fluid embolism (AFE) is a rare but potentially fatal complication that occurs acutely during pregnancy or within 12 h of delivery. The management of AFE focuses initially on supportive measures for cardiopulmonary stabilization. Extracorporeal membrane oxygenation should be considered in patients who are unresponsive to medical treatment in order to prevent additional hypoxia and subsequent organ failure. We present a 41-year-old woman with clinical AFE who developed acute respiratory distress syndrome and was treated successfully with extracorporeal membrane oxygenation.
Adult ; Amniotic Fluid* ; Anoxia ; Embolism ; Embolism, Amniotic Fluid* ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Pregnancy ; Respiratory Distress Syndrome, Adult

Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC) was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO) priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.
Blood Transfusion ; Death, Sudden, Cardiac ; Erythrocyte Transfusion ; Erythrocytes ; Extracorporeal Membrane Oxygenation* ; Heart Arrest* ; Humans ; Hyperkalemia* ; Infant* ; Infant, Newborn ; Potassium

PURPOSE: The purpose of this study was to analyze the types of attitudes of nursing students in Korea toward bucket lists. METHODS: The Q-methodology, which provides a method for analyzing the subjectivity of each item was used. From each of the 37 subjects, 34 selected Q-statements were classified into the shape of a normal distribution, using a 9-point scale. The collected data were analyzed using a QUANL PC program. RESULTS: Four types of attitudes toward the bucket list of subjects were identified in Korean nursing students. Typeis a pursuit of money type, Type II is a pursuit of relationship type, Type III is a pursuit of self-centered type, and Type is a pursuit of others-centered type. CONCLUSION: The results of this study indicate that different approaches toward educational programs for students in the human service area are recommended based on the four types of nursing students' attitudes toward the bucket list.
Humans ; Korea ; Nursing ; Students, Nursing*

Purpose: The purpose of this study was to analyze anxiety and depression among infertile women at different time points during the firstIn Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatment through a systematic review and meta-analysis. Methods: Seven out of 3,011 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performedusing the RevMan 5.3 program. We compared the measurement outcomes at three time points: before the start of treatment (T0), cancellationof treatment after pregnancy detection (T2), one to six months after treatment (T3). The effect size used was the standardizedmean difference (SMD). Results: In comparing the different time points of the pregnant women from their cycle, significantly lower levelsof depression were found at T2 than at T0. In non-pregnant women, anxiety at T2 and depression at T2 and T3 were significantly higherthan those at T0. At T2 and T3, the non-pregnant women reported higher levels of anxiety and depression compared with the pregnantwomen. Conclusion Anxiety and depression in infertile women undergoing the first IVF or ICSI are associated with the time points andpregnancy status after treatment. These findings suggest that attention should be paid to helping infertile women prepare for and copewith treatment and treatment failure.

BACKGROUND/AIMS: The hepat it is C virus (HCV) genotypes have been shown to be differently distributed among distinct geographic areas and as sociated with different clinical present at ions. The aut hors investigated the distribution of HCV genotypes in Korean patients with chronic HCV infection and the as sociation of HCV genotypes with age, sex, severity of the liver disease, and the possible mode of transmission. METHODS: The study population consisted of 143 patients with chronic HCV infect ion: 13 with normal ALT , 78 with chronic hepatitis , 35 with cirrhosis , 17 with hepat ocellular car cinoma (HCC). HCV genotypes were determined by line probe assay. RESULTS: The principal HCV genotype was 1b ( 56%) and followed by 2a/ c ( 32%), mixed (8%), 2b ( 3%), and 1a (1%). Patients infected with type 1b and 2a/ c were older than those with ot her genotypes (p< 0.05). Genotype 1b tended to be more prevalent among patients with HCC ( 76% compared with 53% for patients with other liver diseases ; p=0.07). There was no significant relations hip bet ween genotypes and sex or mode of transmission. CONCLUSION: The most common HCV genotype in Korea was type 1b and followed by 2a/ 2c. Although patients infected with type 1b and 2a/c were older than those with other genotypes, there was no correlation between genotypes and sex, severity of liver disease, or mode of transmission.
Fibrosis ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Hip ; Humans ; Ions ; Korea ; Liver Diseases

Human colon epithelial cells secrete an array of proinflammatory cytokines that includes IL-8, MCP-1, GM-CSF, TNF alpha and IL-6. This response may serve to attract neutrophils and macrophags to the site of infection. In addition to IL-8 and MCP-1, the chemokine family contains other members, which, alone or in combination, can recruit and/or activate inflammatory and lymphoid cells. In this study, we asked whether colon epithelial cells express a broader array of chemokines than previously described. The colon epithelial cell line, Caco-2, was stimulated for 3h with IL-1 alpha, or was infected with Salmonella dublin. RNA was extracted and chemokine mRNA levels were determined by quantitative reverse transcription-PCR using internal RNA standards. Ex pression of GRO alpha, GRO beta, GRO gamma and IP-10 increased by bacterial infection or IL-l alpha stimulation. These data strongly support the notion that epithelal cells are an important and integral component of the host's natural immune system.
Bacterial Infections ; Chemokines ; Colon* ; Cytokines ; Epithelial Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Humans* ; Immune System ; Interleukin-1alpha ; Interleukin-6 ; Interleukin-8 ; Lymphocytes ; Neutrophils ; RNA ; RNA, Messenger ; Salmonella

Objective: Endometrial fibrosis, the primary pathological feature of intrauterine adhesion, may lead to disruption of endometrial tissue structure, menstrual abnormalities, infertility, and recurrent pregnancy loss. At present, no ideal therapeutic strategy exists for this fibrotic disease. Eupatilin, a major pharmacologically active flavone from Artemisia, has been previously reported to act as a potent inducer of dedifferentiation of fibrotic tissue in the liver and lung. However, the effects of eupatilin on endometrial fibrosis have not yet been investigated. In this study, we present the first report on the impact of eupatilin treatment on transforming growth factor beta (TGF-β)-induced endometrial fibrosis. Methods: The efficacy of eupatilin on TGF-β–induced endometrial fibrosis was assessed by examining changes in morphology and the expression levels of fibrosis markers using immunofluorescence staining and quantitative real-time reverse-transcription polymerase chain reaction. Results: Eupatilin treatment significantly reduced the fibrotic activity of TGF-β–induced endometrial fibrosis in Ishikawa cells, which displayed more circular shapes and formed more colonies. Additionally, the effects of eupatilin on fibrotic markers including alpha-smooth muscle actin, hypoxia-inducible factor 1 alpha, collagen type I alpha 1 chain, and matrix metalloproteinase-2, were evaluated in TGF-β–induced endometrial fibrosis. The expression of these markers was highly upregulated by TGF-β pretreatment and recovered to the levels of control cells in response to eupatilin treatment. Conclusion Our findings suggest that suppression of TGF-β–induced signaling by eupatilin might be an effective therapeutic strategy for the treatment of endometrial fibrosis.

Objective: Despite extensive research on implantation failure, little is known about the molecular mechanisms underlying the crosstalk between the embryo and the maternal endometrium, which is critical for successful pregnancy. Profilin 1 (PFN1), which is expressed both in the embryo and in the endometrial epithelium, acts as a potent regulator of actin polymerization and the cytoskeletal network. In this study, we identified the specific role of endometrial PFN1 during embryo implantation. Methods: Morphological alterations depending on the status of PFN1 expression were assessed in PFN1-depleted or control cells grown on Matrigel-coated cover glass. Day-5 mouse embryos were cocultured with Ishikawa cells. Comparisons of the rates of F-actin formation and embryo attachment were performed by measuring the stability of the attached embryo onto PFN1-depleted or control cells. Results: Depletion of PFN1 in endometrial epithelial cells induced a significant reduction in cell-cell adhesion displaying less formation of colonies and a more circular cell shape. Mouse embryos co-cultured with PFN1-depleted cells failed to form actin cytoskeletal networks, whereas more F-actin formation in the direction of surrounding PFN1-intact endometrial epithelial cells was detected. Furthermore, significantly lower embryo attachment stability was observed in PFN1-depleted cells than in control cells. This may have been due to reduced endometrial receptivity caused by impaired actin cytoskeletal networks associated with PFN1 deficiency. Conclusion These observations definitively demonstrate an important role of PFN1 in mediating cell-cell adhesion during the initial stage of embryo implantation and suggest a potential therapeutic target or novel biomarker for patients suffering from implantation failure.

This study was carried out in order to clarify the selection criteria of the surgical approaches and validate their efficacy in patients with vestibular schwannoma. The evolution and modification of the transpetrosal approach was evolved into combined approaches to vestibular schwannomas. These approaches have been advocated to reduce the mortality and morbidity as well as to improve the surgical results especially in large acoustic neurinoma. Having been stimulated with the fascinating preliminary surgical results of the suboccipital and combined transpetrosal approaches, we have builded up a decision making policy based on the tumor size and the preoperative hearing status for the surgical approaches to vestibular schwannomas. Between May 1996 and September 1997, 21 patients with vestibular schwannoma including one case of NF II underwent either suboccipital or various transpetrosal approaches. There was no surgical mortality. Gross total removal was achieved in 20 patients(95%). Facial nerve function was preserved in 19(90%) and hearing function in 6(46%) among the 13 patients who underwent hearing preservation surgery. The authors confirmed the validity of various transpetrosal approaches in this study and conclude that our policy on the surgical approaches to vestibular schwannomas is quite reasonable.
Decision Making ; Facial Nerve ; Hearing ; Humans ; Mortality ; Neuroma, Acoustic* ; Patient Selection*

In this study, the food intake, feces and urine of 14 primary school age boys and girls were collected and intake and excretion of iron and zinc were measured. The boys and girls were 8-12 years old and measurement continued for four weeks during which they maintained their normal living pattern. Each boy's and girl's daily intake and excretion of iron and zinc were measured and apparent digestibility and balance were also calculated. The results are as follows. Mean daily intake of iron was 14.9+/-0.6 mg for the boys and 12.4+/-0.5 mg for the girls. Mean daily intake of zinc was 11.8+/-1.2 mg for the boys and 11.5+/-0.4 mg for the girls. Mean daily fecal loss and apparent digestibility of iron was 6.1+/-0.3 mg and 58.8+/-2.0% for the boys and 6.8+/-0.1 mg and 44.1+/-2.0% for the girls. Mean daily fecal loss and apparent digestibility of zinc was 9.3+/-0.2 mg and 14.4+/-5.1% for the boys and 9.7+/-0.4 mg and 14.3+/-4.3% for the girls. Mean daily urinary loss of iron was 1.1+/-0.1 mg and showed the positive balance of 7.86+/-0.6 mg for the boys and 0.5+/-0.1 mg and showed the positive balance of 5.14+/-0.4 mg for the girls. Mean daily urinary loss of zinc was 0.5+/-0.1 mg and showed the positive balance of 1.03+/-0.6 mg for the girls.
Child* ; Eating ; Feces ; Female ; Humans ; Iron* ; Zinc*