No abstract available.
T-Lymphocytes*

OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

BACKGROUND: Angiotensin II plays a potential role in renal injury not only by its vasoconstrictive effects but also its biochemical effects. alpha-Actinin, an actin-linked glycoprotein, is expressed in podocytes and known to be rearranged and changed in various glomerular diseases. We investigated the effect of angiotensin II on the alpha-actinin in the glomerular epithelial cells to find out the fact that it could be prevented by losartan, a type 1 angiotensin receptor antagonist. METHODS: Glomerular epithelial cells were treated with various concentrations of angiotensin II in culture media, and then we compared the localization and amount of alpha-actinin by confocal microscopy and Western blot analysis, respectively. We also compared the differences in the localization and protein amount of alpha-actinin by various concentrations of losartan in the presence of angiotensin II. In addition, we tried to observe the mRNA expression of alpha-actinin via RT-PCR. RESULTS: The fluorescent and band intensities of alpha-actinin were decreased by angiotensin II in a dose-dependent manner by confocal microscopy and Western blot analysis, respectively. These changes of alpha-actinin by angiotensin II were reversed by losartan in dose dependent manner. Angiotensin II also changed the distribution of alpha-actinin from peripheral to inner cytoplasm in dose-dependent manner, which was also reversed by losartan. The different expression of alpha-actinin m-RNA by RT-PCR were unremarkable. CONCLUSIONS: Angiotensin II decreases the amount of alpha-actinin protein and and makes cytoskeletal changes in glomerular epithelial cells, which could be reversed by losartan. It suggests that it could be prevented by angiotensin II AT1 receptor blockers.

BACKGROUND: Angiotensin II plays a potential role in renal injury not only by its vasoconstrictive effects but also its biochemical effects. alpha-Actinin, an actin-linked glycoprotein, is expressed in podocytes and known to be rearranged and changed in various glomerular diseases. We investigated the effect of angiotensin II on the alpha-actinin in the glomerular epithelial cells to find out the fact that it could be prevented by losartan, a type 1 angiotensin receptor antagonist. METHODS: Glomerular epithelial cells were treated with various concentrations of angiotensin II in culture media, and then we compared the localization and amount of alpha-actinin by confocal microscopy and Western blot analysis, respectively. We also compared the differences in the localization and protein amount of alpha-actinin by various concentrations of losartan in the presence of angiotensin II. In addition, we tried to observe the mRNA expression of alpha-actinin via RT-PCR. RESULTS: The fluorescent and band intensities of alpha-actinin were decreased by angiotensin II in a dose-dependent manner by confocal microscopy and Western blot analysis, respectively. These changes of alpha-actinin by angiotensin II were reversed by losartan in dose dependent manner. Angiotensin II also changed the distribution of alpha-actinin from peripheral to inner cytoplasm in dose-dependent manner, which was also reversed by losartan. The different expression of alpha-actinin m-RNA by RT-PCR were unremarkable. CONCLUSIONS: Angiotensin II decreases the amount of alpha-actinin protein and and makes cytoskeletal changes in glomerular epithelial cells, which could be reversed by losartan. It suggests that it could be prevented by angiotensin II AT1 receptor blockers.

PURPOSE: This descriptive study was aimed at identifying the relations among geriatric nurses' terminal care performance, death anxiety and self-esteem and the factors that affect nurses' terminal care stress. METHODS: Data were collected using a self-reported questionnaire completed by 212 geriatric hospital nurses working in 10 hospitals in K city and B metropolitan city. RESULTS: The survey results showed that the stress factors were terminal care performance and death anxiety. Significant predictors for terminal care stress were death anxiety and terminal care performance. (And the higher the level of death anxiety and terminal care performance were, the heavier the stress was.) These factors explained 32.5% of the variance in terminal care stress. CONCLUSION: The results of the study suggested that terminal care performance was an important factor of terminal care stress for geriatric nurses. Therefore, it seems that it is necessary to develop an educational intervention program to improve nurses' terminal care performance to reduce their terminal care stress.
Anxiety* ; Attitude to Death ; Self Concept ; Stress, Psychological ; Terminal Care*

Osteochondritis dissecans of the capitellum is a condition which causes pain and limitation of motion in the elbow joint. Conservative management can be done in the early stage, but operative method is indicated when conservative treatment failed or loose bodies causing symptoms developed. The authors experienced 20 cases of osteochondritis dissecans of the capitellum, which received satisfatory surgical treatment, such as 1) removal of loose body, 2) removal of loose body, curettage, and multiple drilling, 3) curettage and multiple drilling at the Department of Orthopedic Surgery, National Police Hospital, from January, 1985 to August 1989. Following results were obtained. 1. The occupations were baseball players in 5 cases (25%), gymnast in 4 csses (20%), tennis player in 1 case (5 %), which implicates repetitive trauma or excessive use of the elbow joint as a cause of osteochondritis dissecans of the capitellum. 2. The main symptoms were pain in all cases(100%), limitation of range of moiton(70%), locking(25%), swelling of the joint, and clicks on range of motion in decreasing order. 3. Of the 20 cases, removal of loose bodies was performed in 13 cases(65%), removal of loose bodies, curettage, and multiple drilling in 4 cases (20%), and curettage and multiple drilling in the remaining 3 cases (15%), And follow-up results were excellent in 16 cases (80%), good in 3 cases (15%), and moderate in 1 case (5%). So, we concluded that the above surgical measurements are good enough to give satisfactory results for osteochondritis dissecans of the capitellum.
Baseball ; Curettage ; Elbow Joint ; Follow-Up Studies ; Humans ; Joints ; Methods ; Occupations ; Orthopedics ; Osteochondritis Dissecans ; Osteochondritis ; Police ; Range of Motion, Articular ; Tennis

Congenital vertical talus is dufficult to correct and tends to recur. Reduction of the deformed talon-avicular joint is rarely possible by conservative means alone and consequently surgical reduction is usually necessary. The technique of Kumar, Cowell and Ramsey(TAL, capsular release, open reduction of navicular, and K-wire fixation) was combined with or without tendon transfer using Tibialis anterior(Grice operation) in 11 feet of seven children(bilateral in four) under the age of four(2 girls and 5 boys), and followed them for average 41 months. Three of them were combined with cerebral palsy, syringomyelia, and multiple joint stiffness with camptodactyly. In preoperative radiograms, all of their tali are so distorted plantarward and medially as to be almost vertical. The talus was in an equinus position also but to a lesser degrees. The forefoot was dorsiflexed at the midtarsal joint and the navicular lay on the dorsal aspect of the talar head. Seven feet are corrected normally after operation, but four feet were recurred and soft tissue releasing techniques combined with extraarticular subtalar arthrodesis or triple arthrodesis were planned after their skeletal maturity.
Arthrodesis ; Cerebral Palsy ; Female ; Foot ; Head ; Humans ; Joint Capsule Release ; Joints ; Syringomyelia ; Talus ; Tendon Transfer

No abstract available.
Pancreatic Diseases*

Pulmonary embolism is the impaction of material into branches of the pulmonary arterial bed. It usually occurs in patients with primary hypercoagulable states or secondary hypercoagulable states like cancer, preganancy, and estrogen replacement therapy. We report a case of a pulmonary embolism in a patient with positive lupus anticoagulant who received estrogen replacement therapy. The patient was referred due to suddenly developed shortness of breath and echogenic mass densities in the right atrium on 2 dimensional echocardiography. The patient was markedly improved with intravenous urokinase and subsequent oral anticoagulant therapy. Related articles are also reviewed.
Dyspnea ; Echocardiography ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Heart Atria ; Humans ; Lupus Coagulation Inhibitor* ; Pulmonary Embolism* ; Urokinase-Type Plasminogen Activator

This study was designed to evaluate the efficacy of intravitreal injection of tPA &C3F8 gas in submacular hemorrhage. Fourteen patients with sub-macular hemorrhage received an intravitreal injection of tPA &C3F8 gas and maintained face down position for 2 weeks. We investigated the feature of blood absorption, the correlation between underlying disease, hemorrhage size, duration and visual outcome. Underlying disease seemed to be a prognostic factor related to final visual acuity. Patients with choroidal rupture had better visual prognosis than those with age-related macular degeneration. The duration between the formation of submacular hemorrhage and treatment was correlated with final visual acuity, however, it was not sta-tisticallly significant. We have shown that submacular hemorrhage could be displaced by tPA and C3F8 gas injection in our most cases. In 7 of total 14 cases, visual acuity improved. The result suggests that this technique may be good for the initial treatment if done in appropriate timing in cases of submacular hemorrhage due to its simplicity and it can achieve relatively good results.
Absorption ; Choroid ; Hemorrhage* ; Humans ; Intravitreal Injections ; Macular Degeneration ; Prognosis ; Rupture ; Tissue Plasminogen Activator ; Visual Acuity