To develop optimal shift systems for an improvement of work schedule satisfaction, health and work productivity, the effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological components and work mistakes were investigated in nursing students. Two groups of seven volunteers participated as experimental subjects, apd seven to twenty nursing students participated as a control group. The directions of rotation work shift were as follows CW(clockwise)-shift system rotation in the direction of day shift(3 days), evening shift(3 days), off duty(l day) and night shift(5 days), and CCW (counterclockwise) -shift system rotation in the reverse direction. Urinary Na, K, and Cl levels were measured with ion-selective electrodes. The levels of performance were measured by a questionnaire to determine the number of mistakes in 12 specific items during duty. The disturbance of Na the circadian rhythm was seen on day and night shifts, especially in the CCW-rotation shift system, and the magnitude of the daily variation was greatest in the CCW-rotation system. The daily rhythms of K and Cl shifted to the right on the evening shift, and the rhythms were reversed on the night shift, which suggests that they adapted to the altered shift work. However, the levels of Cl were higher in day and night shift workers, especially in CCW-shift system. In the ease of urine salts, it seems that the students in CW-shift system more easily adapted to the altered shift. The incidence of mistakes during work were more frequent on the CCW shift than in the CW shift. These data indicate that the direction of rotation effects the worker's health and work performance. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt to the shift on a physiological level, and has many more negative effects on the shift workers' health when compared with the CW rotation. Thus, a clockwise rotating shift system seems to be more desirable for the optimal health and performance of nurses.
Appointments and Schedules ; Circadian Rhythm* ; Efficiency ; Humans ; Incidence ; Ion-Selective Electrodes ; Salts ; Students, Nursing ; Volunteers ; Surveys and Questionnaires

OBJECTIVE: p16INK4 and p15INK4B genes are known to be tumor suppressor genes which reside in p21 region of chromosome 9 and are related to cell cycle control as an inhibitor of cyclin-dependent-kinase. We designed this study to search for deletion and decreased expression of p16INK4 and p15INK4B genes in advanced ovarian carcinomas. METHODS: Polymerase chain reaction (PCR)-based analysis was performed to search for deletion of p16INK4 and p15INK4B using DNA extracted from frozen tissue in liquid nitrogen of thirty-one advanced ovarian carcinoma patients. The intensities of PCR bands were analyzed using an imaging densitometer to determine gene dosage in tumor samples and the relative gene dosage was calculated by comparing band intesity of p16INK4 or p15INK4B with that of beta-globin gene. Homozygous deletions were assigned to tumors in which the ratio was reduced to less than 25% in any one of exons of p16INK4 and p15INK4B. Immunohistochemical techniques were used to study the expression of p16INK4. p16-negative cells were characterized by the absence of nuclear staining, whereas cytoplasmic staining was variable. Clinico-pathologic features, complete remission rates and survivals were analyzed according to the status of p16INK4 and p15INK4B genes. RESULTS: Homozygous deletion of p16INK4 was detected in 12.9% of advanced ovarian carcinoma patients and that of p15INK4B in 35.5%. Clinico-pathologic features such as FIGO stage, histological grade, serum CA-125 levels were not different from groups with homozygously deleted p16INK4 and p15INK4B to those with normal genes. The survival of patients (13 [6-20] months) with homozygously deleted p16INK4 was significantly shorter than that (30 [8-52] months) of patients with normal p16INK4 (p=0.046; Log-rank test). CONCLUSION: These observations indicate that deletions of p16INK4 and p15INK4B gene might be involved in tumorigenesis of ovarian carcinoma and could be useful as a prognostic factor. A prospective, controlled study with more patients will be mandatory in the future.
beta-Globins ; Carcinogenesis ; Cell Cycle Checkpoints ; Chromosomes, Human, Pair 9 ; Cytoplasm ; DNA ; Exons ; Gene Dosage ; Genes, Tumor Suppressor ; Humans* ; Immunohistochemistry ; Nitrogen ; Polymerase Chain Reaction

Systemic lupus erythematosus(SLE) is an autoimmune disease characterized by multisystem involvement including central nervous system and various neurologic symptoms. The authors experienced a case of brain SLE and report MRI and other neuroimaging findings.
Autoimmune Diseases ; Brain* ; Central Nervous System ; Magnetic Resonance Imaging* ; Neuroimaging ; Neurologic Manifestations

Abscence of right superior vena cava(SVC) in visceroatrial situs solitus is a rare(0.07% to 0.13%) congenital cardiovascular malformation, and little is known about the type and frequency of additional heart defects and arrhythmias. We reviewed previous publications and report the case of 8 month old male infant with absent right superior vena cava and persistent left superior vena cava and large secundum atrial septal defect, mild pulmonary valvular stenosis.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Heart ; Heart Septal Defects, Atrial* ; Humans ; Infant ; Male ; Vena Cava, Superior*

BACKGROUND: Dopamine receptors are strong candidates for involvement in schizophrenia and are target of a wide variety of antipsychotics. Dopamine D5 receptor(DRD5) gene polymorphisms may be associated with various treatment response. The purpose of our study was define to what significance can be held as a predictor of treatment response in this polymorphism. METHOD: The total number of 116 Korean chronic schizophrenic patients was assessed after 48 weeks treatment. The Positive and Negative Syndrome Scale(PANSS) was rated for the clinical response to various antipsychotics. With the use of polymerase chain reaction amplification, we assessed this dopamine D5 receptor polymorphism in schizophrenic patients who had been treated with antipsychotics, and related genotype with treatment response, to test the hypothesis that DRD5 polymorphism may lead to varying resonse to antipsychotic. RESULT: DRD5 polymorphism was not associated with treatment response to a variety of antipsychotics in chronic schizophrenic patients. CONCLUSION: Genetic variation of D5 receptors do not predict treatment response to antispychotics.
Antipsychotic Agents ; Dopamine* ; Genetic Variation ; Genotype* ; Humans ; Polymerase Chain Reaction ; Receptors, Dopamine ; Receptors, Dopamine D5* ; Schizophrenia

Clinical and pathological studies were carried out on 78 patients of ovarian cancer from January 1985 to March 1991. The results are as follows : l. Among 78 patients of ovarian cancer, the age group from 51 to 60 years old was most common which was 18 cases(23.1%). 2. When classified according to the cell type, epithelial cell origin cancers were 59 cases (75.6%), ovarian cancers from germ cell origin 9 cases(11.5%), sex cord stromal cancers 3 cases(3.8%), and metastatic cancers 7 cases(8.9%) respectively. 3. When classified according to the FIGO staging, stage I were 34 cases(43.5%), stage II 8 cases(10.3%), stage III 23 cases(29.5%) and stage IV 13 cases(16,7%), respectively. 4. Preoperative mean CA 125 value of stage I ovarian cancer was 130.2+/-57.3U/ml, stage II 74.2+/-144.4U/ml, stage III 376.9+/-296.8U/ml and stage IV 433.9+/-148.2U/ml respectively. and Also preoperative mean CEA value of stage I ovarian cancer was 3.4+/-3.2ng/ ml, stage II 6.9+/-4.3ng/ml, stage III 4.7+/-4.4ng/ml and stage IV 4.6+/-6.3ng/ml respectively. 5. When classified according to the physical examination, the most common finding was palpable mass which were 38 cases(43.7%), the second, abdominal pain 30 cases(38.4%) and the third, abdominal distension 21 cases(26.9%) 6. When classified according to the operation, ipsilateral oophorectomy was 15 cases(25.5%), ipsilateral oophorectomy and contralateral ovary wedge resection 6 cases(10.2%), total abdominal hysterectomy 17 cases(28.8%), total abdominal hysterctomy and omentectomy 14 cases(23.7%), total abdominal hysterectomy and omentectomy and debulking tumor resetion 4 cases(6.7%) and biopsy only 3 cases(5.1%) respetctively. 7. When calssifide according to the postoterative endometrial finding, atrophic pattern was 28 cases(65.7%), proliferative pattern 10 cases(28.6%) and secretory pattern 2 cases(5.7%) respectively.
Abdominal Pain ; Biopsy ; Epithelial Cells ; Female ; Germ Cells ; Humans ; Hysterectomy ; Middle Aged ; Ovarian Neoplasms* ; Ovariectomy ; Ovary ; Physical Examination ; Statistics as Topic*

In this study, 20 students in C university were selected by control group and 14 shift work nurses working in C university hospital by test group It took part in case of day shift(8AM-4PM), evening shift(4PM-12MN), and night shift(12MN-8AM) to know a urinary 17-OHCS and free cortisol changes which works in a rapidly rotating shift work system. The working team were an rest period of a day and an oberservation of an week. It obtained an urine specimen before and after work shift in 2nd day. Test group and control group of shift work compared to change of levels of urinary 17-OHCS and free cortisol of urine collected from nurses of day shift, evening shift, and night shift. The data was analyzed by t-test, paired t-test. The results are as follows. 1. Compare 8AM with 4PM in day shift. Control group increased 4.1mg at 8AM, 4.2mg at 4PM in a case of 17-OHCS(p=.84) and also test group increased a little 3.5mg at start time of work, 3.6mg at stop time(p=.97). In a case of free cortisol control group decreased 3.8microgram at 8AM, 2.4microgram at 4PM(p=.12) and test group decreased 8.3microgramat start time of work, 3.2microgram at stop time(p=.22). 2. Compare 4PM with 12MN in evening shift. Control group decreased 4.2mg at 4PM, 2.9mg at 12MN in a case 17-OHCS(p=.54), but test group increased 1.7mgat start time of work, 3.4mg at stop time(p=.07). In a case of free cortisol control group decreased 2.4microgram at 4PM, 1.9microgram AT 12MN(p=.23) and also test group decreased a little 2.6microgram at start time of work, 1microgram at stop time(p=.43). 3. Compared 12MN with 8AM in night shift. Control group increased 3.9mg at 12MN, 4.1mg at 8AM in a case of 17-OHCS(p=.79) and also test group increased 6.3mg at start time of work, 8.4mg at stop time(p=.16). In a case of free cortisol control group increased 1.9microgram at 12MN, 3.8microgram at 8AM(p=.08) and test group increased 4.4microgram at start time of work, 11.6microgram at stop time(p=.04). As a result of this study reveals that health level of nurses is decreased in a rotating shift work(2 days internal). As mentioned above, it was confirmed that the rotating shift work had influence on the health of the nurse. For it, I present the objective base data to measure the level healthy in order to extend the understanding of the physical aspects of the nurses. Moreover, it is considered that one can make use of it as an objective base data with a view to the rational management for the nursing administration.
Health Status ; Humans ; Hydrocortisone* ; Nursing

PURPOSE:Cardiovascular morbidity has recently been demonstrated to potentially reduce life expectancy in growth hormone deficiency(GHD). The aim of this study was to evaluate cardiovascular abnormalities and atherosclerotic changes in adults with childhood-onset GHD in whom GH treatment had been stopped at the achievement of final height. METHODS:Nine patients with childhood-onset GHD(7 idiopathic and 2 organic), with an age of 24.0+/-.0 year, were studied. Clinical characteristics of subjects were determined and blood pressure, body mass index(BMI), and serum concentrations of lipids were measured. Structural and functional evaluation of cardiovascular system was performed by M-mode echocardiography and linear phase array imaging transducer. RESULTS:BMI of patients was 27.3+/-.7 mg/m2, and four patients(44%) were overweight(BMI 25-30 mg/m2), but none was obese(BMI >30 mg/m2). The percentage of patients who had total cholesterol > or = 200 mg/dL, triglyceride > or = 150 mg/dL, LDL cholesterol > or = 140 mg/dL, and HDL cholesterol < or = 40 mg/dL were 56%, 44%, 33 %, and 44%, respectively. Interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular end-diastolic internal diameter (LVID), left ventricular mass index(LVMI) of patients were 6.4+/-2.1 mm(SDS -1.5+/-1.1), 6.3+/-1.2 mm(SDS -2.1+/-0.8), 44.9+/-4.3 mm(SDS -1.0+/-0.9), and 85.4+/-94.8 g/m2 (SDS -0.5+/-6.8), respectively. The number of patients whose IVST, LVPWT, LVID, and LVMI were decreased(<-2SD) were 4(44%), 5(56%), 1(11%), and 6(67%), respectively. Carotid artery intima-media thickness(IMT) was 0.86+/-0.22 mm, and it was increased(>2SD) in 3 patients(33%). Three out of four patients with IVST lower than -2SD had increased carotid artery IMT, whereas none of five patients with IVST higher than -2SD had increased carotid artery IMT. There were no differences in echocardiographic findings between groups according to sex, age, duration of disease, duration after GH discontinuation, BMI, and severity of dyslipidemia. CONCLUSION: Decreases in IVST, LVPWT, and LVMI, and an increase in carotid artery IMT were observed in a significant number of patients with childhood-onset GHD. These findings support the need of GH replacement after completion of growth and careful evaluation of cardiovascular changes in patients with childhood-onset GHD.
Adult* ; Blood Pressure ; Cardiovascular Abnormalities* ; Cardiovascular System ; Carotid Arteries ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Dyslipidemias ; Echocardiography ; Growth Hormone* ; Humans ; Life Expectancy ; Transducers ; Triglycerides

PURPOSE:Improved adult final height(FH) is a major goal in the treatment of children with short stature due to growth hormone deficiency(GHD). The purpose of this study was to evaluate final height in idiopathic and organic GHD children after long-term growth hormone(GH) treatment. METHODS:Twenty five(16 males and 9 females) patients with GHD(14 idiopathic and 11 organic GHD) were included. GHD was diagnosed by two or more GH provocation tests(peak GH level <10 ng/mL). All subjects had multiple pituitary hormone deficiencies, and aged 10.7+/-.5(5.5-14) years at the start of GH treatment. The patients were treated with GH 0.45-0.7 IU/kg/week in 3-7 divided doses for 6.9+/-.8(5.2-10) years. Treatment was ended when growth velocity reached lower than 2 cm/year and/or bone age reached 16 years. Standard auxologic measurements were performed at the start of GH treatment and at every 6 month after initial GH treatment. RESULTS:FH was 166.9+/-.8 cm, which was not significantly lower than target height(167.1+/-.9 cm) and predicted adult height(169.1+/-5 cm). FH SDS was significantly improved to -0.8+/-.5 compared with -3.4+/-.0 of height SDS at the start of GH treatment. The largest height increment was observed in the first year of GH treatment, with a gradual decrease in the following years. There was no difference in FH and FH SDS between idiopathic and organic GHD. Unwanted serious adverse events were not observed in all patients during GH therapy. CONCLUSION: Early diagnosis and continuous treatment with optimal doses of GH to near adult height improve the outcome in children with short stature due to idiopathic and organic GHD.
Adult ; Child* ; Early Diagnosis ; Growth Hormone* ; Humans ; Male

No abstract available.
Adrenal Cortex Hormones* ; Glaucoma*