Dermatophytes infect the human hair, skin, nail and cause the dermatophytosis. The extracellular and intracellular proteinases of the dermatophytes commonly occur in the genus Trichophyton like T. rubrum, T. mentagrophytes, and T. granulosum. These enzymes play a prominent role in growth, multiplication and infection of the host tissue. Extracellular proteinases have been purified from the species of Trichophyton and Microsporum. We purified the proteinase partially from the culture filtrate of the Trichophyton tonsurans through Mono-Q and Superose 12 column and investigated its biochemical and enzymatic characters. The molecular size of the proteinase was estimated to be 41 kDa by SDS-PAGE. And pI was 3.2. The optimal temperature and pH for an enzymatic activity were 27C and 7.5, respectively. The purified porteinase degraded the keratin, bovine serum albumin, hemoglobin. The serine proteinase inhibitor like PMSF and DFP inhibited the proteolytic activity of the purified enzyme whereas the cysteinase inhibitor did not. These results demonstrated that the purified proteinase is a serine proteinase and can contribute the tissue invasion.
Arthrodermataceae ; Electrophoresis, Polyacrylamide Gel ; Hair ; Humans ; Hydrogen-Ion Concentration ; Isoflurophate ; Microsporum ; Peptide Hydrolases ; Serine Proteases* ; Serine* ; Serum Albumin, Bovine ; Skin ; Tinea ; Trichophyton*

PURPOSE: The purpose of this study was to examine the effects of aroma-inhalation on depression, sleep, mood, and smell in stroke patients and their caregivers. METHOD: This study employed one group pretest-posttest repeated design. Data were collected at three time points: baseline(pre-test), 10 days and 20 days after the intervention(post-test1 and post-test2, respectively). The sample included a total of 23 subjects. Data were analyzed by SPSS 12.0 program using repeated measure ANOVA. RESULTS: Depression was not statistically significant difference among pre-test, post-test1 and post-test2. Sleep was improved after intervention: 37.61+/-7.41(pre-test), 41.22+/-8.26 (post-test1), 44.33+/-7.67(post-test2)(F=8.182, p=.001). Mood was significantly improved after intervention: 16.95+/-4.89(pre-test), 14.89+/-6.31 (post-test1), 12.11+/-5.04(post-test2). Smell including smell perception, discomfort due to smell and relation between age and smell was significantly improved after intervention: 2.63+/-1.20(pre-test). 2.00+/-1.16(post-test1), 1.63+/-.96(post-test2)(F=6.176, p=.006) in smell perception, 2.50+/-1.10 (pre-test). 1.81+/-.91(post-test1), 1.19+/-.40(post-test2) (F=12.26, p=.000) in discomfort due to smell and 3.53+/-1.18(pre-test). 2.59+/-1.46(post-test1), 2.53+/-1.33(post-test2)(F=4.148, p=.025) in relation between age and smell. CONCLUSION: The results suggest that aroma-inhalation may have an effect on sleep, mood and smell and can be effective nursing intervention to increase the relaxation in stroke patients and their caregivers.
Aromatherapy* ; Caregivers* ; Depression* ; Humans ; Nursing ; Relaxation ; Smell* ; Stroke*

PURPOSE: The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. METHODS: This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. RESULTS: First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees' ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses' work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. CONCLUSION: In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.
Focus Groups ; Humans ; Korea* ; Licensure* ; Licensure, Nursing ; Nursing* ; Specialization ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Controversy exists regarding the role of endogenous ouabain in the pathogenesis of DOCA-salt induced hypertension. The purpose of this study was to investigate the role of endogenous ouabain in the development of hypertension in DOCA-salt rats. MATERIALS AND METHODS: The mean blood pressure and heart rate were recorded in 1, 2 and 4 week old control and DOCA-salt treated rats. The endogenous levels of ouabain in the plasma, hypothalamus, pituitary and adrenal glands of the 1, 2 and 4 week old control and DOCA-salt treated rats were also measured using a radioimmunoassay. RESULTS: The mean blood pressures in the 2 and 4 week old DOCA-salt treated rats were significantly higher than those of the controls. There was no significant change in the heart rate between the DOCA-salt treated and control groups. In the 4 week old DOCA-salt treated rats, the endogenous level of ouabain in the adrenal glands was higher than that in the control rats, but this was only weakly significant. The endogenous level of ouabain in the hypothalamus was significantly higher in the 1 week old DOCA-salt treated rats than in the control, but this significance disappeared in the 2 and 4 week old DOCA-salt treated rats. CONCLUSION: These results suggest that the endogenous level of ouabain contributes to the development and maintenance of high blood pressure in DOCA-salt rats. Further studies will be required to elucidate the relationship between the endogenous level of ouabain and DOCA-salt hypertension.
Adrenal Glands ; Animals ; Blood Pressure ; Heart Rate ; Hypertension ; Hypothalamus ; Ouabain* ; Plasma ; Radioimmunoassay ; Rats*

This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan. 1985 and Dec. 1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, 78.8%. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor, 19(57.6%) appeared in the right lung and 14 (42.4%) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs. 16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.), 2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was 14.3% while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).
Adrenal Glands ; Appendix ; Brain ; Carcinoma ; Carcinoma, Large Cell* ; Diagnosis ; Female ; Humans ; Lung* ; Male ; Neoplasm Metastasis ; Pancreas ; Pleural Effusion ; Retrospective Studies ; Skin ; Survival Rate

Purpose: The aim of this study is to evaluate the effect of body mass index (BMI) on peak serum growth hormone (GH) level after GH stimulation test in children with short stature. Methods: Data were obtained from retrospective medical record reviews of those who visited the pediatric endocrine clinic at St. Vincent’s Hospital of Catholic University for short stature from January 2010 to June 2019. A total of 115 children (66 boys and 49 girls) whose height was less than the third percentile according to age and sex underwent GH stimulation testing. Results: Of the 115 subjects, 47 were diagnosed with GH deficiency (GHD) and 68 were diagnosed with idiopathic short stature (ISS). In patients with GHD, weight standard deviation score (SDS) (P<0.001) and BMI SDS (P≤0.001) were higher, and free thyroxine (T4) level (P=0.012) was lower than those in the ISS group. In total subjects, peak serum GH level after GH stimulation test showed negative correlations with weight SDS (r=-0.465, P<0.001), BMI SDS (r=-0.398, P<0.001), and thyroid stimulating hormone (r=-0.248, P=0.008) and a positive correlation with free T4 (r=0.326, P<0.001). In multiple regression analysis, BMI SDS (P=0.003) was negatively associated with peak serum GH level in GH stimulation testing after adjusting for age, sex, pubertal status, and type of pharmacological stimulus. Conclusion The BMI SDS influences peak serum GH level after GH stimulation testing. We should consider BMI factors when interpreting the results of GH stimulation testing.

Neonatal diabetes mellitus can be categorized as transient, permanent, or syndromic, and approximately half of the cases are transient. We present a case involving a term newborn who showed overt progression of transient neonatal diabetes mellitus, with complete remission within 6 months. On the second day of life, the patient presented with tachypnea, hyperglycemia, and decreased serum levels of C-peptide and insulin. Continuous subcutaneous infusion of insulin and continuous glucose monitoring were well tolerated. The patient showed a normal growth pattern, with no hyperglycemic or hypoglycemic episodes at 6 months of age. As it is rare and often asymptomatic, hyperglycemia may be attributed to various factors, including intrauterine environment, perinatal stress, and diverse genetic background. Therefore, consistent blood glucose monitoring and prompt early insulin therapy are crucial for any term newborns with persistent hyperglycemia, to prevent further diabetic complications. Moreover, continuous subcutaneous insulin infusion and the utilization of continuous glucose monitoring devices are the most effective and practical management strategies.

Neonatal diabetes mellitus can be categorized as transient, permanent, or syndromic, and approximately half of the cases are transient. We present a case involving a term newborn who showed overt progression of transient neonatal diabetes mellitus, with complete remission within 6 months. On the second day of life, the patient presented with tachypnea, hyperglycemia, and decreased serum levels of C-peptide and insulin. Continuous subcutaneous infusion of insulin and continuous glucose monitoring were well tolerated. The patient showed a normal growth pattern, with no hyperglycemic or hypoglycemic episodes at 6 months of age. As it is rare and often asymptomatic, hyperglycemia may be attributed to various factors, including intrauterine environment, perinatal stress, and diverse genetic background. Therefore, consistent blood glucose monitoring and prompt early insulin therapy are crucial for any term newborns with persistent hyperglycemia, to prevent further diabetic complications. Moreover, continuous subcutaneous insulin infusion and the utilization of continuous glucose monitoring devices are the most effective and practical management strategies.

Purpose: The aim of this study is to evaluate the effect of body mass index (BMI) on peak serum growth hormone (GH) level after GH stimulation test in children with short stature. Methods: Data were obtained from retrospective medical record reviews of those who visited the pediatric endocrine clinic at St. Vincent’s Hospital of Catholic University for short stature from January 2010 to June 2019. A total of 115 children (66 boys and 49 girls) whose height was less than the third percentile according to age and sex underwent GH stimulation testing. Results: Of the 115 subjects, 47 were diagnosed with GH deficiency (GHD) and 68 were diagnosed with idiopathic short stature (ISS). In patients with GHD, weight standard deviation score (SDS) (P<0.001) and BMI SDS (P≤0.001) were higher, and free thyroxine (T4) level (P=0.012) was lower than those in the ISS group. In total subjects, peak serum GH level after GH stimulation test showed negative correlations with weight SDS (r=-0.465, P<0.001), BMI SDS (r=-0.398, P<0.001), and thyroid stimulating hormone (r=-0.248, P=0.008) and a positive correlation with free T4 (r=0.326, P<0.001). In multiple regression analysis, BMI SDS (P=0.003) was negatively associated with peak serum GH level in GH stimulation testing after adjusting for age, sex, pubertal status, and type of pharmacological stimulus. Conclusion The BMI SDS influences peak serum GH level after GH stimulation testing. We should consider BMI factors when interpreting the results of GH stimulation testing.

PURPOSE: It has been reported that daily recombinant human growth hormone (GH) treatment showed beneficial effects on growth in prepubertal children with idiopathic short stature (ISS). The present study aimed to validate the GH (Eutropin(R)) effect on growth promotion and safety after short-term GH treatment. MATERIALS AND METHODS: This study was an open-label, multicenter, interventional study conducted at nine university hospitals in Korea between 2008 and 2009. Thirty six prepubertal children with ISS were enrolled in this study to receive 6-month GH treatment. Yearly growth rate, height standard deviation score (SDS), and adverse events were investigated during treatment. RESULTS: After 26 weeks of GH treatment, the height velocity significantly increased by 6.36+/-3.36 cm/year (p<0.001). The lower end of one-sided 95% confidence interval was 5.22 cm/year, far greater than the predefined effect size. The gain in height SDS at week 26 was 0.57+/-0.27 (p<0.0001). Bone age significantly increased after GH treatment, however, bone maturation rate (bone age for chronological age) showed limited advancement. This 26-week GH treatment was effective in increasing serum levels of insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-3 from baseline (p<0.0001). Eutropin was well tolerated and there were no withdrawals due to adverse events. No clinically significant changes in laboratory values were observed. CONCLUSION: This 6-month daily GH treatment in children with ISS demonstrated increased height velocity, improved height SDS, and increased IGF-I and IGFBP-3 levels with a favorable safety profile.
Child ; Female ; Growth Disorders/blood/*drug therapy ; Growth Hormone/*therapeutic use ; Humans ; Insulin-Like Growth Factor Binding Protein 3/blood ; Insulin-Like Growth Factor I/metabolism ; Male ; Treatment Outcome