PURPOSE: The purpose of this study was to develop a breastfeeding empowerment program and to investigate the effects of the breastfeeding empowerment program on self-efficacy, adaptation and continuation of breastfeeding for primiparous women. METHODS: The 5 session breastfeeding empowerment program was developed and a non-equivalent control group non-synchronized quasi-experiment design was used. Fifty-five participants were assigned to either the experimental group (n=27) or the control group (n=28). Effects were tested using repeated measures ANOVA and χ²-test. RESULTS: Scores for self-efficacy, adaptation and continuation of breastfeeding of in the experimental group after program were significantly higher than 1 week, 4 weeks, 8 weeks scores in control group. CONCLUSION: The effects of the breastfeeding empowerment program for elevating self-efficacy, adaptation and continuation of breastfeeding in primiparous women were validated. Therefore, this program can be recommended for vigorous use in clinical practice.
Breast Feeding* ; Female ; Humans ; Power (Psychology)* ; Self Efficacy

A case of a 58-year-old man with malignant fibrous histiocytoma (MFH) of the right ventricle is reported light and electron microscopically. This is the first case of MFH of the heart in the Korean literature. A tendency for malignant fibrous histiocytoma of the heart to occur in the left atrium of young women is suggested; this sarcoma's usual location is in the soft tissue of elderly men. The tumor consisted of spindle cells arranged in a focal storiform patterns, clusters or sheets of histocyte-like cells, benign and malignant giant cells, inflammatory cells, scattered mitotic figures and anaplasia of stromal cells. In ultrastructure the constituent of cells of the tumor are primitive mesenchymal cells, histiocytoid cells and fibroblast like cells including giant cells.
Female ; Male ; Humans

Withaferin A (WFA) is known as a constituent of Ayurvedic medicinal plant, Withania somnifera, and has been used for thousands of years. Although WFA has been used for the treatment of osteoarthritis (OA) and has a wide range of biochemical and pharmacologic activities, there are no findings suggesting its properties on chondrocytes or cartilage. The aim of the present study is to investigate the effects of WFA on apoptosis with focus on generation of intracellular reactive oxygen species (ROS). Here we showed that WFA significantly increased the generation of intracellular ROS in a dose-dependent manner. We also determined that WFA markedly leads to apoptosis as evidenced by accumulation of p53 by Western blot analysis. N-Acetyl-L-Cystein (NAC), an antioxidant, prevented WFA-caused expression of p53 and inhibited apoptosis of chondrocytes. We also found that WFA causes the activation of PI3K/Akt and JNKinase. Inhibition of PI3K/Akt and JNKinase with LY294002 (LY)/triciribine (TB) or SP600125 (SP) in WFA-treated cells reduced accumulation of p53 and inhibited fragmented DNA. Our findings suggested that apoptosis caused by WFA-induced intracellular ROS generation is regulated through PI3K/Akt and JNKinase in rabbit articular chondrocytes.
Animals ; Anti-Inflammatory Agents/administration & dosage ; Apoptosis/drug effects/physiology ; Cartilage, Articular/cytology/drug effects/*metabolism ; Cells, Cultured ; Chondrocytes/drug effects/*metabolism ; Dose-Response Relationship, Drug ; MAP Kinase Kinase 4/*metabolism ; Phosphatidylinositol 3-Kinases/*metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; Rabbits ; Reactive Oxygen Species/*metabolism ; Withanolides/*administration & dosage

The computer-aided design/computer-aided manufacturing (CAD/CAM) system was introduced to shorten the production time of all-ceramic restorations and the number of patient visits. Among these types of ceramic for dental CAD/CAM, they have been processed into inlay, onlay, and crown shapes using leucite-reinforced glass-ceramics to improve strength. The purpose of this study was to observe the mechanical properties and microstructure of leucite-reinforced glass-ceramics for dental CAD/CAM. Two types of leucite-reinforced glass-ceramic blocks (IPS Empress CAD, Rosetta BM) were prepared with diameter of 13 mm and thickness of 1 mm. Biaxial flexural testing was conducted using a piston-on-three-ball method at a crosshead speed of 0.5 mm/min. Weibull statistics were used for the analysis of biaxial flexural strength. Fracture toughness was obtained using an indentation fracture method. Specimens were observed by field emission scanning electron microscopy to examine the microstructure of the leucite crystalline phase after acid etching with 0.5% hydrofluoric acid aqueous solution for 1 minute. The results of strength testing showed that IPS Empress CAD had a mean value of 158.1±8.6 MPa and Rosetta BM of 172.3±8.3 MPa. The fracture toughness results showed that IPS Empress CAD had a mean value of 1.28±0.19 MPa·m(1/2) and Rosetta BM of 1.38±0.12 MPa·m(1/2). The Rosetta BM sample exhibited higher strength and fracture toughness. Moreover, the crystalline phase size and ratio were increased in the Rosetta BM sample. The above results are expected to elucidate the basic mechanical properties and crystal structure characteristics of IPS Empress CAD and Rosetta BM. Additionally, they will help develop leucite-reinforced glass-ceramic materials for CAD/CAM.
Ceramics ; Crowns ; Crystallins ; Humans ; Hydrofluoric Acid ; Inlays ; Methods ; Microscopy, Electron, Scanning

Cyclooxygenase-2 (COX-2) is known to modulate bone metabolism, including bone formation and resorption. Because cartilage serves as a template for endochondral bone formation and because cartilage development is initiated by the differentiation of mesenchymal cells into chondrocytes (Ahrens et al., 1977; Sandell and Adler, 1999; Solursh, 1989), it is of interest to know whether COX-2 expression affect chondrocyte differentiation. Therefore, we investigated the effects of COX-2 protein on differentiation in rabbit articular chondrocyte and chick limb bud mesenchymal cells. Overexpression of COX-2 protein was induced by the COX-2 cDNA transfection. Ectopic expression of COX-2 was sufficient to causes dedifferentiation in articular chondrocytes as determined by the expression of type II collagen via Alcian blue staining and Western blot. Also, COX-2 overexpression caused suppression of SOX-9 expression, a major transcription factor that regulates type II collagen expression, as indicated by the Western blot and RT-PCR. We further examined ectopic expression of COX-2 in chondrifying mesenchymal cells. As expected, COX-2 cDNA transfection blocked cartilage nodule formation as determined by Alcian blue staining. Our results collectively suggest that COX-2 overexpression causes dedifferentiation in articular chondrocytes and inhibits chondrogenic differentiation of mesenchymal cells.
Animals ; Cartilage, Articular/cytology ; Cell Differentiation ; Cells, Cultured ; Chick Embryo ; Chondrocytes/*cytology/enzymology ; Chondrogenesis ; Collagen Type II/metabolism ; Cyclooxygenase 2/*biosynthesis/genetics ; Interleukin-1beta/pharmacology ; Mesenchymal Stem Cells/*cytology/enzymology ; Rabbits ; SOX9 Transcription Factor/metabolism

BACKGROUND: Caveolin, a family of integral membrane proteins are a principal component of caveolae membranes. In this study, we investigated the effect of p38 kinase on differentiation and on inflammatory responses in sodium nitroprusside (SNP)- treated chondrocytes. METHODS: Rabbit articular chondrocytes were prepared from cartilage slices of 2-week-old New Zealand white rabbits by enzymatic digestion. SNP was used as a nitric oxide (NO) donor. In this experiments measuring SNP dose response, primary chondrocytes were treated with various concentrations of SNP for 24 h. The time course of the SNP response was determined by incubating cells with 1 mM SNP for the indicated time period (0~24 h). The cyclooxygenase-2 (COX-2) and type II collagen expression levels were determined by immunoblot analysis, and prostaglandin E2 (PGE2) assay was used to measure the COX-2 activity. The tyrosine phosphorylation of caveolin-1 was determined by immunoblot analysis and immunostaining. RESULTS: SNP treatment stimulated tyrosine phosphorylation of caveolin-1 and activation of p38 kinase. SNP additionally caused dedifferentiation and inflammatory response. We showed previously that SNP treatment stimulated activation of p38 kinase and ERK-1/-2. Inhibition of p38 kinase with SB203580 reduced caveolin-1 tyrosine phosphorylation and COX-2 expression but enhanced dedifferentiation, whereas inhibition of ERK with PD98059 did not affect caveolin-1 tyrosine phosphorylation levels, suggesting that ERK at least is not related to dedifferentiation and COX-2 expression through caveolin-1 tyrosine phosphorylation. CONCLUSION: Our results indicate that SNP in articular chondrocytes stimulates dedifferentiation and inflammatory response via p38 kinase signaling in association with caveolin-1 phosphorylation.
Cartilage ; Caveolae ; Caveolin 1 ; Chondrocytes* ; Collagen Type II ; Cyclooxygenase 2* ; Digestion ; Dinoprostone ; Humans ; Membrane Proteins ; Membranes ; Nitric Oxide ; Nitroprusside ; Phosphorylation ; Phosphotransferases* ; Rabbits ; Tissue Donors ; Tyrosine

BACKGROUND: Although adult immunization is as important as childhood immunization, is being inadequately performed. However, previous studies concerning adult immunization could not be sufficiently evaluate because studies were restricted to the residents in rural area or those who have visited a doctor. METHOD: We conducted a study by telephone interview which included 201 household(375 adult family members) selected by systematic sampling from the yellow pages of Kangnam-gu and Sungbuk-gu districts of Seoul. The types of immunization covered in this study were immunizations against hepatitis B, influenza, pneumococcus, and hemorrhagic fever with renal syndrome(HFRS). Immunization status of all adult household members, cognition of the feed for immunization and of interviewees were surveyed. Sex, age, area of residency, education medical history of study subjects were considered as factors related to the cognition of the need for immunization and immunization performance. RESULT: The cognition rates of immunization were as follows: hepatitis B 85.1%, influenza 45.8% pneumonra 38.3%, and HFRS 38.3%. In the people over 65 years old, the cognition rate against influenza and pneumococeus were 6.25%, 6.25% respectively and for those she have chronic disease.80.0%, 20.0%, respectively. The cognition rates of immunization was significantly higher among those subject who were young, well educated, and those residing in Kangnam-gu district. The immunization performance rate of hepatitis B was 6.5%, influenza 5.6%, pneumonia 0.8%, and HFRS 1.1%. 75.5% of subjects vaccinated against hepatitis B had received at least three titles. The immunization performance rate of influenza and pneumococcus by the immunization indication are as follows 8.0%, 0.0%, respectively in the subjects over 65 years old, and 11.1%, 0.0,% respectively in the people who have chronic disease. The immunization performance rate of hepatitis B was higher among young, well educated subjects living in Kangnam-gu district. But age, education, area of residency played no apparent role in the case of other types of immunization. The immunization performance rate of those who felt the need for immunization as significant1y higher then that of those who did not. To assess the factors which re]ate to the correct cognition for immunization necessity, we used a multiple logistic regression test. For all types of immunization surveyed, sex(femals) and age (young) seemed to be significantly related to the correct necessity cognition. Medical history of chronic disease was also related to the correct necessity cognition for immunization against hepatitis B and influenza. CONCLUSION: This study reveals that among living in urban area the immunization performance rate and the correct cognition rate concerning the necessity for adult immunization was generally very low. Therefore, an active publicity and pubic education will be needed to increase the level of correct necessity cognition for immunization in which the disease status, sex, and age of vaccinee are considered. And more active effort to increase the cognition for immunization necessity performance is required.
Adult* ; Aged ; Chronic Disease ; Cognition* ; Education ; Family Characteristics ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Hepatitis B ; Humans ; Immunization* ; Influenza, Human ; Internship and Residency ; Interviews as Topic ; Logistic Models ; Pneumonia ; Seoul ; Streptococcus pneumoniae

BACKGROUND: The aim of this study was to investigate the health problems which women feel important and what they want to know from their doctors in the family practice clinics. METHODS: The subjects were all female patients who visited the family practice clinics at the four hospitals in which some members of the Study Group for Women's Health in Korean Academy of Family Medicine worked from December 10 to 15, 2001. We surveyed by self-administered questionnaire on important health topic, health care services they woud like to receive, what they expected from their doctors, what topics they have difficulty in discussing with, the doctors preference of physician's gender. We analyzed the results by age groups; 19~44, 45~64, and 65 years old and over. RESULTS: A total of 437 women answered the questionnaires, whose mean age was 49.4 year. Health topics that women felt important were osteoporosis, stress, cervical cancer, arthritis, and stroke, which varied with the age groups and recent health perception. The provision of health care services which they desired were in the order of treatment, prevention and health promotion, and diagnosis, which varied with the age groups and recent health perception. What they expected from their doctors were in the order of giving accurate diagnosis, explaining the treatment plan, and answering their questions. They had difficulty undergoing physical exam undressed, gynecological exam, and discussing on their sexual problems. CONCLUSION: Women who visited the family practice clinics felt differently on important health problems according to the age groups. Overall, they wanted to receive health services on the treatment, prevention and health promotion of osteoporosis, stress, cervical cancer, and arthritis.
Aged ; Arthritis ; Attitude to Health ; Delivery of Health Care ; Diagnosis ; Family Practice ; Female ; Gynecological Examination ; Health Promotion ; Health Services ; Humans ; Osteoporosis ; Patient Education as Topic ; Stroke ; Uterine Cervical Neoplasms ; Women's Health ; Surveys and Questionnaires

Background: Larger middle molecules are important substances associated with cardiovascular complications in end- stage renal disease. Unfortunately, larger middle molecules are not reliably removed by a high-flux dialyzer. A medium cut-off (MCO) membrane could effectively remove larger middle molecules. This study aimed to identify the long -term effect of the MCO membrane for changes of larger middle molecules. Methods: Thirty-four patients were prospectively analyzed for 12 months. The enrolled patients were divided into control and MCO groups. We measured the plasma levels of growth differentiation factor 15, sclerostin, and fibroblast growth factor 23 in larger middle molecules and those of biomarkers including small solutes. Single-pool Kt/V (spKt/V) and reduction ratios also were evaluated. Results: Plasma sclerostin did not increase significantly in patients using the MCO dialyzer (135.3 [–637.7 to 908.3], p = 0.715). And there was a significant difference in change of plasma sclerostin level between the two groups (–1,646.9 [–3,015.2 to –278.7], p = 0.033). Furthermore, a negative association between calcium and sclerostin was not observed in the MCO group (r = –0.142, p = 0.587). Solute clearance of larger middle molecules in the MCO group was significantly higher. Moreover, spKt/V values for patients in the MCO group were significantly increased without albumin loss. Values are presented as mean (95% confidence interval [CI]) or adjusted mean (95% CI). Conclusion The MCO dialyzer can increase dialytic adequacy and suppress the increase in plasma sclerostin level without significant albumin loss in patients with end-stage renal disease.

Background: Larger middle molecules are important substances associated with cardiovascular complications in end- stage renal disease. Unfortunately, larger middle molecules are not reliably removed by a high-flux dialyzer. A medium cut-off (MCO) membrane could effectively remove larger middle molecules. This study aimed to identify the long -term effect of the MCO membrane for changes of larger middle molecules. Methods: Thirty-four patients were prospectively analyzed for 12 months. The enrolled patients were divided into control and MCO groups. We measured the plasma levels of growth differentiation factor 15, sclerostin, and fibroblast growth factor 23 in larger middle molecules and those of biomarkers including small solutes. Single-pool Kt/V (spKt/V) and reduction ratios also were evaluated. Results: Plasma sclerostin did not increase significantly in patients using the MCO dialyzer (135.3 [–637.7 to 908.3], p = 0.715). And there was a significant difference in change of plasma sclerostin level between the two groups (–1,646.9 [–3,015.2 to –278.7], p = 0.033). Furthermore, a negative association between calcium and sclerostin was not observed in the MCO group (r = –0.142, p = 0.587). Solute clearance of larger middle molecules in the MCO group was significantly higher. Moreover, spKt/V values for patients in the MCO group were significantly increased without albumin loss. Values are presented as mean (95% confidence interval [CI]) or adjusted mean (95% CI). Conclusion The MCO dialyzer can increase dialytic adequacy and suppress the increase in plasma sclerostin level without significant albumin loss in patients with end-stage renal disease.