BACKGROUND: Poly (ADP-ribose) polymerase (PARP) has been described as an important candidate for mediation of neurotoxicity after brain ischemia. This study was purposed to evaluate the effects of a PARP inhibitor on hypoxic-ischemic injury in the neonatal rat brain. In this study, a highly potent inhibitor of PARP, 3, 4-Dihydro-5-[4-(1-piperidinyl) butoxy]-1 (2H)-isoquinolinone (DPQ) was investigated. METHODS: Seven-day old Sprague-Dawley rat pups were used. The right common carotid artery was ligated under halothane anesthesia. After a recovery period of 3 hours, they were exposed to 8% oxygen at 37degreesC for about 120 minutes. The animals were divided into four groups: the pre-treatment group (n = 13) and post-treatment group (n = 21) were given DPQ 10 mg/kg and the pre-control group (n = 7) and post-control group (n = 14) were given a vehicle for controls. Pre-treatment and pre-control groups were injected 30 minutes prior to the hypoxic injury while post-treatment and post-control groups were injected 30 minutes after the hypoxic period intraperitoneally. The right cerebral hemisphere of the rats were examined with localized (1)H magnetic resonance spectroscopy on day 1 and 7 after the hypoxic insult. Lipid/N-acetyl aspartate (Lip/NAA) and lipid/creatine (Lip/Cr) ratios were used as apoptotic markers. On day 14, the degree of brain injury was scored by morphological changes. RESULTS: In the DPQ treated groups, the Lip/NAA and Lip/Cr ratios were lower than those of the control groups on day 1 after the hypoxic-ischemic injury (P < 0.05). However on day 7, only the ratios of the pre-treatment group were lower than those of the control group (P < 0.05). The degree of morphological changes of the brain injury on day 14 were lower in the DPQ treated groups (P < 0.05). CONCLUSIONS: These results suggest that DPQ exerts a neuroprotective effect in cerebral hypoxic-ischemic injury probably by inhibiting apoptosis especially in the early stage after an insult. Acute inhibition of PARP can have a therapeutic value in preventing ischemic brain injury.
Anesthesia ; Animals ; Apoptosis ; Aspartic Acid ; Brain Injuries ; Brain Ischemia ; Brain* ; Carotid Artery, Common ; Cerebrum ; Halothane ; Magnetic Resonance Spectroscopy ; Negotiating ; Neuroprotective Agents ; Oxygen ; Rats* ; Rats, Sprague-Dawley

OBJECTIVE: Type D personality can be regarded as a promising cardiovascular risk marker that has been repeatedly linked to relevant indicators of mental health, quality of life, morbidity, and mortality in cardiac patients. Heart rate variability (HRV) is a non-invasive technology that can provide information regarding a patient's sympathetic/parasympathetic balance and the control mechanisms of the autonomic systems in the cardiovascular system. As both type D personality and HRV are parameters related to the cardiovascular system, we assumed a relationship between type D personality and HRV. This study set out to identify the relationship between type D and HRV and the differences in HRV variables between type D and non-type D personalities. METHODS: Patients who visited Guro Community Mental Health Center from January 2011 to December 2012 were surveyed. They were evaluated using both the Korean version of the Type D Personality-14 for type D personality and HRV. During the survey, those who reported major cardiovascular disease that can affect heart rate variability were excluded from the study. RESULTS: Our analysis included 559 participants, 249 of whom were classified as type D personality. No significant differences were found in the HRV variables between the type D group and the non-type D group. There were also no clinically meaningful correlations between HRV variables and type D total/subscale scores when controlled for patient age. CONCLUSION: A relationship between HRV and type D personality was not identified using short-term HRV measurements in non-clinical patients with no definitive cardiovascular disease. Further studies using long-term HRV measurements in patients with cardiovascular disease are necessary to conclude an association between HRV and type D personality.
Cardiovascular Diseases ; Cardiovascular System ; Heart Rate* ; Humans ; Mental Health* ; Mortality ; Quality of Life ; Type D Personality*

An inflammatory myofibroblastic tumor (IMT) is a rare benign hepatic neoplasm that is characterized by a mass of localized proliferations of fibroblasts and infiltrations of mononuclear inflammatory cells. An IMT can occur in a variety of locations, including the lung, orbit, parotid, pleura and stomach. However, they have rarely been encountered in the liver. An IMT of the liver most often presents in young adults. The clinical presentations of a hepatic IMT vary: asymtomatic, fever, abdominal pain, palpable mass, vomiting, obstructive jaundice, anemia and hepatosplenomegaly. Their radiographic appearance and clinical presentation make them extremely difficult to distinguish from a malignant neoplasm, preoperatively. Therefore, surgical management is used when a malignancy can not be excluded preoperatively or when the IMT produces a biliary obstruction. We encountered a 31-year-old male patient who is still alive for 38 months following a resection for symtomatic IMT.
Abdominal Pain ; Adult* ; Anemia ; Fever ; Fibroblasts ; Granuloma, Plasma Cell ; Humans ; Jaundice, Obstructive ; Liver Neoplasms ; Liver* ; Lung ; Male ; Myofibroblasts* ; Orbit ; Pleura ; Stomach ; Vomiting ; Young Adult

PURPOSE: The aim of our study was to evaluate the usefulness of high-resolution CT scans in addition tohelical CT for characterizing a solitary pulmonary nodule. MATERIALS AND METHODS: Our study included 49 patientswith a solitary pulmonary nodule ; in each patient this was evaluated by both additional high-resolution CT andhelical scanning. Images were evaluated by three independent observers, each of whom read them twice : initiallywith helical CT images only and then with helical images plus high-resolution CT images. After analysis, theobservers recorded the following : histologic diagnosis, benignancy or malignancy of a nodule, and confidence intheir diagnosis (three scales). RESULTS: In differentiating benign and malignant nodules, the accuracy of helicalscans only was 75% (110/147 readings) whereas that of helical plus high-resolution CT scans was 82% (121/147readings) (p=0.001). Correct histologic diagnosis was made in 47% of cases (69/147 readings) when helical scansonly had been evaluated and in 48% of cases (71/147 readings) for which both helical and high-resolotion CT scanswere available (p=0.815). Diagnosis was more often highly confident on the basis of additional high-resolution CTscans (25%) than helical scans only (5%) (p=0.001) . CONCLUSION: By enhancing differential diagnosticaccuracy between benign and malignant nodules and by increasing confidence in the histologic diagnosis of apulmonary nodule, additional high-resolution CT scans are valuable for the evaluation of a solitary pulmonarynodule.
Diagnosis ; Humans ; Solitary Pulmonary Nodule* ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

PURPOSE: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). METHODS: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. RESULTS: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was ‘Manage maternal ventilator’ (15.09) and the lowest DC was ‘Provide nursing care for leisure to gestation extension mother’ (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was ‘Check fetal heartbeat with electronic fetal heart monitor’. CONCLUSION: The organized educational program and policy was needed to develop for MFICU nurses.
Critical Care ; Delivery Rooms ; Education ; Fetal Heart ; Intensive Care Units ; Leisure Activities ; Nursing ; Nursing Care ; Pregnancy

Purpose: This study aimed to evaluate the level of professional ethics awareness and medical ethics competency in order to assess the potential need for ethics items to be included on the Korean Dental Hygienist Licensing Examination. Methods: In total, 358 clinical dental hygienists and dental hygiene students completed a structured questionnaire to evaluate their level of ethical awareness and medical ethics competency. The sub-factors of medical ethics were classified into relationships with patients, medical and social relations, and individual specialized fields. Results: Only 32.1% of participants indicated that they had taken a course on professional ethics in the university curriculum, but 95.2% of respondents considered professional ethics to be important. The overall score for medical ethics competency was average (3.37 out of 5). The score for relationships with patients was 3.75 points, followed by medical and social relations (3.19 points) and individual specialized fields (3.16 points). The level of professional ethics awareness was higher among participants who had taken a course on professional ethics than among those who had not done so or who did not remember whether they had done so. Conclusion Dental hygienists were aware of the importance of professional ethics, but their medical ethics competency was moderate. Therefore, medical ethics should be treated as a required subject in the university curriculum, and medical ethics competency evaluations should be strengthened by adding ethics items to the Korean Dental Hygienist Licensing Examination.

BACKGROUND: Osteoprotegerin (OPG) is a soluble glycoprotein which inhibits osteoclastogenesis through binding to receptor activator of nuclear factor-kappaB ligand (RANKL). OPG-knockout mice develop early-onset osteoporosis and arterial calcification. Recent studies report that serum OPG levels are elevated in diabetic patients with cardiovascular disease and are associated with the presence and severity of coronary artery disease. We examined the relationships between serum OPG levels and insulin resistance, bone metabolism and cardiovascular risk factors in diabetic patients. METHODS: In 84 diabetic patients (33 men, 51 women, mean age 56.7 years old) were studied. Blood pressure, body mass index (BMI), fasting blood glucose, postprandial 2-hour blood glucose, fasting insulin and lipid profiles were measured. Serum OPG levels were measured with sandwich ELISA method. Bone mineral density (BMD)s were checked and serum osteocalcin and urine deoxypyridinoline levels were checked as bone turnover markers. 24-hour urine microalbumin were checked and left ventricular mass index (LVMI) were evaluated with echocardiography. From simple chest X-ray, the presence of aortic calcification were confirmed by a trained radiologist. Homeostatic model assessment (HOMA)-insulin resistance (IR), quantitative insulin sensitivity check index (QUICKI) were calculated as insulin resistance indices. RESULTS: Serum OPG levels were positively correlated with age, LVMI, HOMA and negatively correlated with lumbar spine BMD and QUICKI. After adjustment for age, only LVMI showed persistent correlation with serum OPG levels and when multiple regression analysis was performed with LVMI as the dependent variable, BMI and OPG were the significant predictors of LVMI (R2=0.054, p=0.012). Dividing the subjects into 3 groups according to 24-hour urine microalbumin levels, mean values for serum OPG levels increased as 24-hours urine microalbumin levels increased, but without statistical significance. Mean serum OPG levels were higher in patients with aortic calcification, without statistical significance. CONCLUSION: Serum OPG levels were positively correlated with insulin resistance indices and negatively correlated with lumbar spine BMD in diabetic patients, suggesting a compensatory mechanism to counteract bone loss progression. Serum OPG levels were independent predictor for LVMI in diabetic patients, warranting further research on OPG as the marker for future cardiovascular mortality in diabetic patients.
Animals ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Female ; Glycoproteins ; Humans ; Hypertrophy, Left Ventricular ; Insulin Resistance* ; Insulin* ; Male ; Metabolism* ; Mice ; Mortality ; Osteocalcin ; Osteoporosis ; Osteoprotegerin* ; RANK Ligand ; Risk Factors* ; Spine ; Thorax

This study was performed to select the proper assessing methods for learning outcomes in undergraduate education of medical humanities (MH), and to evaluate whether student assessments in MH curricula are related to the graduate outcomes (GO)and/or periodic phase outcomes (PO). We searched the reasonable assessing methods for GO and PO of MH curricula of Keimyung University School of Medicine (KUSM). The outcomes are composed of six competencies including patient care, communication, patient support, professionalism, problem solving and research, and self-development. Then, we analyzed whether student assessments carried out during formal MH curricula properly achieved their PO, furthermore their GO. Four competencies including communication, patient support, professionalism, self-development were lightened to be closely related to outcomes for MH. Only the component of problem solving was settled to be related to MH in the competency of problem solving and research. The competency of patient care was excluded from the relationship with MH. The assessing methods for the GO and three PO recommended from educational experts, and there were various available assessing methods based on medical situations and clinical contexts including direct observation of clinical skills, 360 degree feedback, peer review, self-assessment, project-based assessment, portfolio-based assessment, discussion & presentation-based assessment, log-based assessment. For the outcome-achieving from formal MH curricula, the MH programs of phase-1 (1st and 2nd grades) almost accomplished the PO of communication, patient supporting and professionalism, and considerably accomplished the PO of problem solving and self-development. The MH programs of phase-2 (3rd and 4th grades) accomplished considerably their PO as the competencies of professionalism and problem solving, and partially as communication, patient supporting and self-development. However, as only one program, public health law, was provided for MH program in phase-3 (5th and 6th grades), the extra methods to evaluate their MH outcomes are needed. Many assessing methods can be available for the most MH competencies consisting of the GO of KUSM, and the proper assessing methods for each MH competency should be selected based on programs and learning contexts in MH education. While formal MH curricula of the school variously accomplished the MH competencies of GO according to periodic phases of curricula, it is recommended to enhance the feasibility and effectiveness of evaluation for GO in MH curricula of the school.