Purpose: This study evaluated the impact of auricular acupressure on depression among nurses. Methods: This study used a randomized control group pretest-posttest design. Shift-work nurses with the Patient Health Questionnaire-9 (PHQ-9) score over 5 points were randomized to the experimental group(n=20) or the control group(n=20). For the experimental group, auricular acupressure was conducted at the corresponding points of depression (TGI, AH1) weekly for seven days as well as for two weeks. The PHQ-9 was completed before intervention, as well as two weeks after intervention. Results: The mean difference in the PHQ-9 score before and after auricular acupressure in the experimental group (-4.11±2.27), was more significant than in the control group (-1.72±3.82) (t=2.28, p=.03). Conclusion Result showed that nurses who received auricular acupressure had a decrease in depression, compared to those who did not receive auricular acupressure. Further research is required, to apply the other auricular acupressure points, to evaluate the impact on depressive symptoms.

The retinal degeneration resulting from elevated intraocular pressure was evaluated through functional and morphological analyses, for better understanding of the pathophysiology of glaucoma. Ocular hypertension was induced via unilateral episcleral venous cauterization in rats. Experimental time was set at 1 and 3 days, and 1, 2, 4, and 8 weeks post-operation. Retinal function was analyzed using electroretinography. For morphological analysis, retinal tissues were processed for immunochemistry by using antibodies against the calcium-sensing receptor and calcium-binding proteins. Apoptosis was analyzed using the TUNEL method and electron microscopy. Amplitudes of a- and b-wave in scotopic and photopic responses were found to be reduced in all glaucomatous retinas. Photopic negative response for ganglion cell function significantly reduced from 1-day and more significantly reduced in 2-week glaucoma. Calcium-sensing receptor immunoreactivity in ganglion cells remarkably reduced at 8 weeks; conversely, protein amounts increased significantly. Calcium-binding proteins immunoreactivity in amacrine cells clearly reduced at 8 weeks, despite of uneven changes in protein amounts. Apoptosis appeared in both photoreceptors and ganglion cells in 8-week glaucomatous retina. Apoptotic feature of photoreceptors was typical, whereas that of ganglion cells was necrotic in nature. These findings suggest that elevated intraocular pressure affects the sensitivity of photoreceptors and retinal ganglion cells, and leads to apoptotic death. The calcium-sensing receptor may be a useful detector for alteration of extracellular calcium levels surrounding the ganglion cells.
Amacrine Cells ; Animals ; Antibodies ; Apoptosis ; Calcium ; Calcium-Binding Proteins ; Cautery ; Electroretinography ; Ganglion Cysts ; Glaucoma ; Immunochemistry ; In Situ Nick-End Labeling ; Intraocular Pressure ; Methods ; Microscopy, Electron ; Ocular Hypertension ; Rats ; Receptors, Calcium-Sensing ; Retina ; Retinal Degeneration ; Retinal Ganglion Cells ; Retinaldehyde

Diabetic retinopathy is characterized by the pericyte loss, microaneurysms and neovascularization eventually leads to blindness. The present study was examined changes of the microvasculature histochemically and immunochemically in the diabetic rat retina previously documented neuronal alterations, in order to verify the usefulness of the animal model of diabetes for the pathophysiology of angiogenesis. Diabetic condition was induced by a single intravenous injection of streptozotocin in Sprague-Dawley rats aged of 8weeks. The animals showing high blood glucose levels (above 300 mg/dL) were cared for 1, 4, 8, and 12 weeks, respectively. The retinas were processed for Griffonia simplicifolia isolection (GSI) B4 histochmistry, and anti-alpha-smooth muscle actin (alpha-SMA) and anti-NG2 immunochemical techniques. The retinal vasculature was well demarcated by endothelial profiles with GSIB4 histochemistry. alpha-SMA immunoreactivity appeared in the arterioles and the primary capillaries, and NG2 in the arterioles and the whole capillary beds. Changes evoked by diabetes were largely occurred in the capillary. Compared to the retina at normal state, the capillary networks were more complicated, enlarged, and dense. NG2 reactivity was reduced especially under the cytoplasmic processes of the pericytes. In the near periphery of the capillary mainly in the ganglion cell layer of the diabetes, GSIB4 reactive microglia were distributed. These results suggest that the retinal microvasculature showed the precedent events of neovascularization due to diabetes and rat model of diabetes is useful for study of neovascularization mechanism of the diabetic retinopathy.
Actins ; Aged ; Animals ; Arterioles ; Blindness ; Blood Glucose ; Capillaries ; Cytoplasm ; Diabetic Retinopathy ; Ganglion Cysts ; Griffonia ; Humans ; Immunochemistry ; Injections, Intravenous ; Microglia ; Microvessels ; Models, Animal ; Muscles ; Neurons ; Pericytes ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; Streptozocin

The purpose of this study was to investigate the application of various electroretinography (ERG) to the diagnosis of inner retinal dysfunction induced by mild intraocular pressure (IOP) elevation in a rat glaucoma model. For inner retinal function measurements, available photopic ERG protocols were applied under various light conditions including monochromatic combinations, which complement conventional scotopic ERG. Three episcleral veins in the right eyes of Sprague-Dawley rats were cauterized to induce an experimental model of glaucoma, leading to mild IOP elevation. ERG responses were measured before surgery and at 1, 2, 4, and 8 weeks after cauterization. We first confirmed that the amplitude reduction in the standard photopic b-wave was almost comparable to the amplitudes of scotopic a- and b-waves in glaucomatous eyes over time. We have implemented additional photopic ERG protocols under different stimulus conditions, which consisted of a longer duration and different monochromatic combinations. Such a change in the stimulations resulted in more pronounced differences in response between the two groups. Especially in normal animals, blue stimulation on a green background produced the largest b-wave and photopic negative response (PhNR) amplitudes and caused more pronounced oscillatory potential (OP) wavelets (individual components). In glaucomatous eyes, blue stimulation on a green background significantly reduced PhNR amplitudes and abolished the robust OP components. These results, by providing the usefulness of blue on green combination, suggest the applicable photopic ERG protocol that complements the conventional ERG methods of accessing the progression of glaucomatous damage in the rat retina.
Animals ; Cautery ; Complement System Proteins ; Diagnosis ; Electroretinography ; Glaucoma* ; Intraocular Pressure ; Models, Theoretical ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Retinaldehyde ; Veins

PURPOSE: Under the rising demand of health services, the critical pathway (CP) which standardizes the practice guideline was introduced as a means to provide quality healthcare service. CP may increase the patient's satisfaction rate by providing systematic and consistent service. We aimed to evaluate the significance of CP by development and application of CP to patients undergoing laparoscopic cholecystectomy. METHODS: From June 2010 to July 2011, 148 patients underwent elective laparoscopic cholecystectomy. Patients were divided into two groups, including 57 patients in the CP group and 91 patients in the non-CP group. In a retrospective review, related hospital costs were analyzed and compared for both groups. Survey results on satisfaction for the CP group were also analyzed. RESULTS: The mean age was 22.7 years in the CP group and 37.9 years in the non-CP group. Number of hospitalized days was one day for the CP group and 2.51 days for the Non-CP group with p<0.001. In cost analysis all variables showed a significant reduction in the CP group compared to the Non-CP group. The satisfaction rate in the CP group scored 8 points out of 10. CONCLUSION: Results have shown benefit from the financial point of the view for the CP group. Current inclusion criteria for CP are limited and still in development for a solid protocol. Further efforts with a large-scale comparative study to broaden the indication for CP are desired.
Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Costs and Cost Analysis ; Critical Pathways* ; Delivery of Health Care ; Health Services ; Hospital Costs ; Humans ; Retrospective Studies

The reaction of neuroactive substances to ischemic conditions in the rat retina evoked by different methods was immunochemically evaluated in adult Sprague-Dawley rats. Ocular ischemic conditions were unilaterally produced by elevating intraocular pressure (EIOP) or by middle cerebral artery occlusion (MCAO). Two EF-hand calcium binding proteins, calbindin D28K (CB) and calretinin (CR), in the normal retina showed similar immunolocalization, such as the amacrine and displaced amacrine cells, the ganglion cells, and their processes, particularly CB in horizontal cells. CB immunoreactive neurons in the ganglion cell layer in both types of ischemic retinas were more reduced in number than CR neurons compared to those in a normal retina. The CB protein level in both ischemic retinas was reduced to 60-80% of normal. The CR protein level in MCAO retinas was reduced to about 80% of normal but increased gradually to the normal value, whereas that in the EIOP showed a gradual reduction and a slight recovery. SMI32 immunoreactivity, which detects a dephosphorylated epitope of neurofilaments-M and -H, appeared in the axon bundles of ganglion cells in the innermost nerve fiber layer of normal retinas. The reactivity in the nerve fiber bundles appeared to only increase slightly in EIOP retinas, whereas a moderate increase occurred in MCAO retinas. The SMI32 protein level in MCAO retinas showed a gradual increasing tendency, whereas that in the EIOP showed a slight fluctuation. Interestingly, the MCAO retinas showed additional SMI32 immunoreactivity in the cell soma of presumed ganglion cells, whereas that of EIOP appeared in the Muller proximal radial fibers. Glial fibrillary acidic protein (GFAP) immunoreactivity appeared in the astrocytes located in the nerve fiber layer of normal retinas. Additional GFAP immunoreactivity appeared in the Muller glial fibers deep in EIOP retinas and at the proximal end in MCAO retinas. These findings suggest that the neurons in the ganglion cell layer undergo degenerative changes in response to ischemia, although EIOP retinas represented a remarkable Muller glial reaction, whereas MCAO retinas had only a small-scaled axonal transport disturbance.
Adult ; Amacrine Cells ; Animals ; Astrocytes ; Axonal Transport ; Axons ; Calcium-Binding Protein, Vitamin D-Dependent ; Calcium-Binding Proteins ; Carisoprodol ; Ganglion Cysts ; Glial Fibrillary Acidic Protein ; Humans ; Infarction, Middle Cerebral Artery ; Intraocular Pressure ; Ischemia ; Middle Cerebral Artery ; Nerve Fibers ; Neurons ; Rats ; Rats, Sprague-Dawley ; Reference Values ; Retina

BACKGROUND: Propofol increases the risk of bradycardia compared with other anesthetics. This paper reports the heart rate response to intravenous atropine during propofol and enflurane anesthesia. METHODS: Sixty patients undergoing a transabdominal hysterectomy under general anesthesia were randomly assigned to two groups: the propofol group and the enflurane group. All the patients received midazolam 2 mg intramuscularly and were then anesthetized with propofol or enflurane. The blood pressure and heart rate were taken at 1 min intervals for 10 min after a bolus injection of atropine 5microgram/kg. RESULTS: In the enflurane group, the systolic blood pressure and heart rate were increased significantly at 1, 2 and 3 min after the atropine injection (P<0.05). When the two groups were compared, the heart rate in the enflurane group was significantly higher at 1, 2 and 3 min after atropine injection than in the propofol group (P<0.05). CONCLUSIONS: The heart rate response to intravenous atropine during propofol anesthesia is attenuated compared with enflurane anesthesia.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Atropine* ; Blood Pressure ; Bradycardia ; Enflurane* ; Heart Rate* ; Heart* ; Humans ; Hysterectomy ; Midazolam ; Propofol*

PURPOSE: The purpose of this study was to investigate the relationships between LLFDI and quality of sleep in older men with prostatic hypertrophic symptoms. METHODS: The secondary analysis of data collected for the 2nd stage BK(Brain Korea)21 project was performed. The original data were collected using a cross-sectional, face-to-face, and private interview method. The questionnaires consisted of prostatic hypertrophic symptoms, late-life function and disability, quality of sleep, and demographic profiles. RESULTS: A total of 112 older men included in this study. The major findings of this study were as follow; 1) 29.5% of participants had more than moderate symptoms of prostatic hypertrophy. 2) There were a significant positive correlation of prostatic hypertrophic symptoms with subjective sleep quality, sleep latency, sleep disturbances, use of sleeping medication, and daytime dysfunction found, whereas there was a negative relationship with frequency dimension. 3) The LLFDI is significantly associated with urgency, weak stream, and intermittency. The quality of sleep is significantly associated with weak stream which explained 11.2% of variance. CONCLUSION: These results may contribute to a better understanding late-life function and disability, quality of sleep in older men with prostatic hypertrophic symptoms. Therefore, health programs for prompting older men's health should be planned based on results of the study.
Humans ; Male ; Men's Health ; Prostatic Hyperplasia ; Rivers

In order to test if nestin is a useful marker for various types of progenitor cells, we explored nestin expression in the retina during development. Nestin expression was co-evaluated with bromodeoxyuridine (BrdU) labeling and Griffonia simplicifolia isolectin B4 (GSIB4) histochemistry. Nestin immunoreactivity appears in cell soma of dividing neural progenitor cells and their leading processes in retinas from embryonic day (E) 13 to E20, in accordance with a BrdU-labeled pattern. At postnatal day (P) 5, it is restricted to the end feet of Muller cells. BrdU-labeled nuclei were mainly in the inner part of the inner nuclear layer in postnatal neonates. The retinal vessels demarcated with GSIB4-positive endothelial cells were first distributed in the nerve fiber layer from P3. Afterward the vascular branches sprouted and penetrated deeply into the retina. The endothelial cells positive for GSIB4 and the pericytes in the microvessels were additionally immunoreactive for nestin. Interestingly, the presumed migrating microglial cells showing only GSIB4 reactivity preceded the microvessels throughout the neuroblast layer during vascular sprouting and extension. These findings may suggest that nestin expression represents the proliferation and movement potential of the neural progenitor cells as well as the progenitor cells of the endothelial cell and the pericyte during retinal development. Thus, Muller glial cells might be potential neural progenitor cells of the retina, and the retinal microvasculature established by both the endothelial and the pericyte progenitor cells via vasculogenesis along microglia migrating routes sustains its angiogenic potential.
Bromodeoxyuridine ; Carisoprodol ; Endothelial Cells ; Foot ; Griffonia ; Humans ; Infant, Newborn ; Intermediate Filament Proteins ; Lectins ; Microglia ; Microvessels ; Nerve Fibers ; Nerve Tissue Proteins ; Neurogenesis ; Neuroglia ; Pericytes ; Plant Lectins ; Retina ; Retinal Vessels ; Retinaldehyde ; Stem Cells

It has been previously reported that parvalbumin expression was downregulated in AII amacrine cells, while upregulated in a subset of cone bipolar cells electrically synapse with AII amacrine cell in the streptozotocin-induced diabetic rat retina. In the present study, we aimed to trace biochemical changes of pre-synaptic neurons to AII amacrine cells in rat retina following diabetic injury. Diabetic condition was induced by streptozotocin injection into Sprague-Dawley rats aged of 8 weeks. The experimental term of induced diabetes was set at 1, 4, 12 and 24 weeks. Changes of pre-synaptic neurons were evaluated by immunohistochemistry and Western blot analysis with anti-protein kinase C (PKC)-alpha and anti-tyrosine hydroxylase (TH) antibodies. Rod bipolar cells immunolocalized with PKC-alpha antibody extended their enlarged axon terminals into stratum 5 of the inner plexiform layer. In later diabetes, the axon was shorten and its terminals of rod bipolar cell are slightly enlarged. The protein levels of PKC-alpha were slightly increased along with the duration of diabetes. TH immunoreactive neurons are morphologically classified into two subtypes of amacrine cells in the inner nuclear layer: one (type 1) has large soma with long and primary dendrites, classified with dopaminergic, and the other (type 2) has small soma with dendritic arborization. In the outermost inner plexiform layer, ring-like structures being composed of type 1 cell processes were densely distributed. In diabetic retina, the intensity of TH immunoreactivity in type 1 neurons was reduced. In accordance with morphological changes, the protein levels of TH were reduced during diabetes. These results demonstrate that TH immunoreactive dopaminergic amacrine cells are more susceptible to diabetic injury than the rod bipolar cells in the rat retina and may suggest that downregulation of parvalbumin expression in AII amacrine cells of diabetic retina is mainly due to dysfunction of pre-synaptic dopaminergic amacrine cells.
Amacrine Cells* ; Animals ; Antibodies ; Axons ; Blotting, Western ; Carisoprodol ; Dendrites ; Down-Regulation ; Immunohistochemistry ; Neurons* ; Phosphotransferases ; Presynaptic Terminals ; Rats* ; Rats, Sprague-Dawley ; Retina* ; Streptozocin ; Synapses