Bone formation by osteoblast may be closely related to the increase in intracellular Ca2+ activity of osteoblast. In order to study the effects of changes in Ca2+ activity of osteoblast-like cell on fracture healing, we changed intracellular Ca2+ activity of osteoblast-like cells by vanadate and verapamil. And the process of fracture healing was observed after injection of the treatment osteoblast-like cells into the fracture site by hematoxylin-eosin (H-E) stain and bromodeoxyuridine (BrdU) stain. The results were as follow: 1) The most effective range of concentration which could facilitate bone formation was 10-6 to 10-5 M. 2) H-E stain showed more abundant osteoblast and osteoid tissues, more active mitotic division of osteoblast, and earlier appearance of chondroblast and chondroid tissue, making the maturation of woven bone faster in the vanadate-treated group than in the control group. The opposite was true in the verapamil-treated group compared with the control group. 3) BrdU labeling index showed more active osteoblastic proliferation in the vanadate-treated than in the control group. The opposite was observed in the verapamil-treated group compared with the control group. From these results, the fracture healing appears to be facilitated and decelerated by vanadate which apparently increase intracellular Ca2+ activity of osteoblast and verapamil which decreases it, repectively. Therefore the change of intracellular Ca2+ activity of osteoblast can be considered to be one of fracture healing mechanisms and expected to be applied for clinical purpose.
Bromodeoxyuridine ; Chondrocytes ; Fracture Healing ; Osteoblasts ; Osteogenesis ; Vanadates ; Verapamil

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

This study was understand in order to examine the effect of hardness on stress-causing factors, defined in this study as burnout in nursing. The subjects were 248 nurses working in three general hospitals in Taejon. The instruments used for this study were a survey of general characteristics, modified Health-Related Hardiness Scale(HRHS) (25 items), job stress scale (63 items), and burnout scale(20 items). Analysis of data was done through the mean, percentage, Person correlation coefficient, and stepwise multiple regression done with a SAS program. The results of this study are as follows. 1) The average item score for the job stress was high at 4.44. In the subcategories, the highest degree of stress was night duty(5.11), and work overload(4.70), responsibility for extra affairs(4.70), conflict in nurse-doctor relationships(4.69), and low reward (4.63) in that order. 2) In the stepwise multiple regression analysis, hardiness(11.55%) was a significant determinant of burnout along with job stress(17.24%) and job duration(12.94%). The results of this study show that hardiness has an effect on psychological distress caused by stress.
Daejeon ; Hardness ; Hospitals, General ; Humans ; Nursing ; Reward

Purpose: To report a case of type III Usher syndrome that has not been previously reported in the Republic of Korea.Case summary: A 39-year-old female visited the local eye clinic for ophthalmic evaluation and then visited our ophthalmologydepartment due to a need for further evaluation and proper management. She complained of night blindness after she becamean adult. She underwent a funduscopic examination, which revealed decolorization and atrophy of the retinal pigment epithelium,bony spicule pigmentation in the retina, and thinning of the retinal arteriole. Results of an electroretinogram and electrooculogramrevealed that responses were weak. She was diagnosed with the fourth grade of hearing impairment according to hermedical history. There was no mental retardation. According to her family history, her mother had hypermetropia, and her brotherhad astigmatism. There was no other medical history, including ophthalmic history. She was diagnosed with type III Usher syndromebased on ataxia and the dynamic visual acuity test. Conclusions It may be necessary to consider a genetic disease by assessing other systemic symptoms when a patient with retinitispigmentosa is diagnosed.

PURPOSE: To report a case of a Corynebacterium macginleyi-infected corneal ulcer of a patient who had been treated for conjunctivitis for more than 3 months. CASE SUMMARY: A 72-year-old female was transferred from a private ophthalmic clinic for evaluation of herpetic keratitis with progressive corneal edema and infiltration in the left eye. She had a history of conjunctival hyperemia and eyeball pain in her left eye 3 months prior to her visit. She was treated with levofloxacin eye drops and acyclovir ointment (Herpesid®, Samil, Co., Ltd. Seoul, Korea). On slit lamp examination, 5.4 × 4.0 mm corneal epithelial defects and stromal infiltrations were observed in the upper to central cornea, and endothelial keratic precipitates were found. Gram positive bacteria were detected on Gram staining and Corynebacterium macginleyi was identified on bacterial cultures from the conjunctiva and cornea. She was treated with topical vancomycin eye drops. After 3 months of treatment, the corneal ulcer was completely resolved, leaving mild superficial opacity on the cornea. CONCLUSIONS: While Corynebacterium macginleyi, normal flora of the conjunctiva, is considered a major causative agent for conjunctivitis and blepharitis, Corynebacterium macginleyi should also be considered a possible cause of slowly progressive keratitis in patients with chronic conjunctivitis.
Acyclovir ; Aged ; Blepharitis ; Conjunctiva ; Conjunctivitis ; Cornea ; Corneal Edema ; Corneal Ulcer ; Corynebacterium ; Female ; Gram-Positive Bacteria ; Humans ; Hyperemia ; Keratitis ; Keratitis, Herpetic ; Levofloxacin ; Ophthalmic Solutions ; Seoul ; Slit Lamp ; Vancomycin

PURPOSE: To report a case of unilateral loss of reflex tearing after double-jaw surgery with anatomy and mechanism.CASE SUMMARY: A 32-year-old woman complained of a 3-year history of loss of tearing in her left eye. She had undergone double-jaw surgery 3 years prior to correct her malocclusion. In orbital computed tomography (CT) images, there were no specific findings, with the exception of a fractured left pterygoid plate, possibly caused by the double-jaw surgery. The tear break-up times of both eyes were similar, with non-specific findings on slit lamp examination. We diagnosed loss of reflex tearing due to pterygopalatine ganglion injury based on her history, physical examination and orbital CT findings. CONCLUSIONS Nerve damage due to artificial fracture may occur during double-jaw surgery and may result in loss of reflex tearing, thus, pre-operative evaluation of basic lacrimal secretion and a reflex tearing test are important. Once the loss of reflex tearing due to nerve injury occurrs, orbital CT scans are needed for diagnosis. Ophthalmologist examination is necessary to confirm the mechanism of loss of reflex tearing and changes in the anatomical structure.

A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperative waiting area, and a combination of dexmedetomidine and remifentanil was continuously infused for most of anesthetic time. To control blood pressure, bolus injection of remifentanil and low-dose infusion of sodium nitroprusside, nicardipine, and esmolol were administered during three adrenergic crises. There was minimal post-resection hypotension, and his trachea was extubated safely 20 min after the surgery. He was discharged without noticeable complication. His catecholamine levels showed the steadily decreasing pattern during the operation in this case. Though a combination of dexmedetomidine and remifentanil may not prevent the hemodynamic instability impeccably during the tumor manipulation, this combination seems to be the way of interrupting release of catecholamines and minimizing hemodynamic fluctuations.
Adolescent ; Atenolol ; Blood Pressure ; Catecholamines ; Cerebral Hemorrhage ; Dexmedetomidine ; Hemodynamics ; Humans ; Hypotension ; Losartan ; Nicardipine ; Nitroprusside ; Pheochromocytoma ; Piperidines ; Piracetam ; Prazosin ; Propanolamines ; Seizures ; Trachea

The classic presentation of renal cell carcinoma (pain, hematuria, and flank mass) occurs in a minority of patients and often is indicative of advanced disease. Common sites of metastatic renal cell carcinoma are lung, soft tissues, bone, and liver. Paranasal sinus is an unusual site for metastasis of renal cell carcinoma. One 73-year-old male presented to Soonchunhyang University Seoul Hospital with melena. Renal cell carcinoma with metastasis to duodenum was diagnosed by computed tomography (CT). He underwent right radical nephrectomy and Whipple's operation. Positron emission tomography/CT was performed postoperatively, and then metastasis to maxillary sinus was found by accident. He was treated with molecular targeted therapy (pazopanib hydrochloride 800 mg).
Aged ; Bone and Bones ; Carcinoma, Renal Cell* ; Duodenum ; Electrons ; Hematuria ; Humans ; Liver ; Lung ; Male ; Maxillary Sinus* ; Melena ; Molecular Targeted Therapy ; Neoplasm Metastasis* ; Nephrectomy ; Seoul

From July, 1989 to June, 1998 forty-two patients with malignant germ cell tumors of the ovary treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center, were identified. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up of those patients were reviewed retrospectively. The patients with malignant germ cell tumor constituted 11.1% of all ovarian malignancies and 5.6% of all ovarian germ cell tumors ecountered during this period. The most common histologic subtype was dysgerminoma (26.2%) followed by endodermal sinus tumor (23.8%) and immature teratoma (19.0%). The age of the patients ranged from 8 to 64 years (mean+/-S.D.; 26.0+/-12.9) and the mean parity was 0.8 (+/-1.6). The most frequent initial symptoms were adbominal pain (33.3%) or abdominal distension (31.0%). Most had stage I(25 cases, 59.9%) or II(6 cases, 14.3%) diseases. Elevated level of serum alpha-FP was observed in all cases of endodermal sinus tumor and embryonal cell carcinoma, CA 125 was elevated in 63.9% of all malignant germ cell tumors. Thirty-one patients (73.8%) were treated by surgery and chemotherapy and 10 patients (23.8%) by surgery only. The major chemotherapeutic regimens were BEP (bleomycin +etoposide +cisplatin) and VAC (vincristine +actinomycin-D +cytoxan). The mean follow-up duration was 24.6 (+/-23.5) months and 2-year survival rate was 88.6% (+/-0.6).
Chungcheongnam-do ; Drug Therapy ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Parity ; Retrospective Studies ; Survival Rate ; Teratoma ; Ulsan

Congenital intracranial teratoma is rare and it's prognosis is very poor with death usually occurring after birth. Moreover it is very rare for intracranial teratoma to be diagnosed in utero. Recently, we experienced a case of fetal intracranial teratoma at 26 weeks of gestation, which is placed in the middle area of cranial cavity. On the monitor of ultrasonogram, the mass was seen as a hyperechogenic mass and its size was 20~30 mm in diameter and it was located in the region of thalamus. The finding of microscopic examination was that neuroepithelial and neuroglial nests and primitive epithelial cells were aggregated and this finding was consistent with immature teratoma. We report a case with a brief review of the literature.
Epithelial Cells ; Parturition ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Teratoma* ; Thalamus ; Ultrasonography