PURPOSE: Today, an increasing number of divorce is shifting family forms and gender role practices. The purpose of this qualitative study was to understand life's experiences of middle-aged divorced women with higher education and profession lives in Korea. METHODS: For this study, 6 middle-aged divorced women with similar backgrounds were recruited from December 2013 to June 2014, using in-depth individual interviews. Data analysis was performed using Giorgi's phenomenological methodology. RESULTS: Individual interviews revealed the following 15 meaning of themes and 5 themes. 1) A woman considering herself to be ashamed that she has not lived an ordinary life. 2) The destiny of a woman not having a fortune. 3) An exhilarated mood like a teenage girl's 4) Suppressing an instinctive desire of sex. 5) Being a mother as a woman head of household. CONCLUSION: This study provides deep understanding of middle-aged divorced women with higher levels of education and professional lives of women who experienced difficult times and overcame their problems. Based on the results of this study, nursing strategies for enhancing quality of life need to be created and implemented for all professional women by Korean community networking gradually.
Community Networks ; Divorce* ; Education* ; Family Characteristics ; Female ; Gender Identity ; Humans ; Instinct ; Korea ; Middle Aged ; Mothers ; Nursing ; Quality of Life ; Statistics as Topic

Excessive influx and the subsequent rapid cytosolic elevation of Ca²⁺ in neurons is the major cause to induce hyperexcitability and irreversible cell damage although it is an essential ion for cellular signalings. Therefore, most neurons exhibit several cellular mechanisms to homeostatically regulate cytosolic Ca²⁺ level in normal as well as pathological conditions. Delayed rectifier K⁺ channels (I(DR) channels) play a role to suppress membrane excitability by inducing K⁺ outflow in various conditions, indicating their potential role in preventing pathogenic conditions and cell damage under Ca²⁺-mediated excitotoxic conditions. In the present study, we electrophysiologically evaluated the response of IDR channels to hyperexcitable conditions induced by high Ca²⁺ pretreatment (3.6 mM, for 24 hours) in cultured hippocampal neurons. In results, high Ca²⁺-treatment significantly increased the amplitude of IDR without changes of gating kinetics. Nimodipine but not APV blocked Ca²⁺-induced IDR enhancement, confirming that the change of I(DR) might be targeted by Ca²⁺ influx through voltage-dependent Ca²⁺ channels (VDCCs) rather than NMDA receptors (NMDARs). The VDCC-mediated I(DR) enhancement was not affected by either Ca²⁺-induced Ca²⁺ release (CICR) or small conductance Ca²⁺-activated K⁺ channels (SK channels). Furthermore, PP2 but not H89 completely abolished I(DR) enhancement under high Ca²⁺ condition, indicating that the activation of Src family tyrosine kinases (SFKs) is required for Ca²⁺-mediated I(DR) enhancement. Thus, SFKs may be sensitive to excessive Ca²⁺ influx through VDCCs and enhance I(DR) to activate a neuroprotective mechanism against Ca²⁺-mediated hyperexcitability in neurons.
Animals ; Calcium Channels ; Cytosol ; Humans ; Kinetics ; Membranes ; Neurons* ; Nimodipine ; Protein-Tyrosine Kinases* ; Rats* ; Receptors, N-Methyl-D-Aspartate ; src-Family Kinases ; Tyrosine*

PURPOSE: This study was undertaken to determine the neuroprotective effect of granulocyte stimulating factor (G-CSF) on neonatal hypoxic-ischemic brain injury. MATERIALS AND METHODS: Seven-day-old male newborn rat pups were subjected to 110 minutes of 8% oxygen following a unilateral carotid artery ligation. Apoptosis was identified by performing terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining and flow cytometry with a combination of fluorescinated annexin V and propidium iodide (PI) and JC-1 (5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolyl-carbocyanine iodide). The extent of cerebral infarction was evaluated at 2 weeks after recovery. RESULTS: With a single dose (50microgram/kg) of G-CSF treatment immediately after hypoxic-ischemic insult, hypoxia-ischemia induced increase in TUNEL-positive cells, annexinV+/PI- and JC-1 positive apoptotic cells in the ipsilateral cerebral cortex was significantly reduced at 24 hours, measured by flow cytometry, and the extent of cerebral infarction at 2 weeks after recovery was also significantly attenuated compared to the hypoxia-ischemia control group. CONCLUSION: Our data suggest that G-CSF is neuroprotective by inhibiting apoptosis, thereby reducing the ensuing cerebral infarction in a newborn rat pup model of cerebral hypoxia-ischemia (HI).
Animals ; Apoptosis/*drug effects ; Brain/pathology ; Cerebral Infarction/pathology/prevention & control ; Flow Cytometry ; Granulocyte Colony-Stimulating Factor/*pharmacology/therapeutic use ; Hypoxia-Ischemia, Brain/*drug therapy/pathology ; In Situ Nick-End Labeling ; Male ; Organ Size ; Protective Agents/*pharmacology/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Weight Gain

The aim of this study was to investigate the effect of erythropoietin (EPO) on histological brain injury, subventricular zone (SVZ) expansion, and sensorimotor function deficits induced by hypoxia-ischemia (HI) in newborn rat pups. Seven-day-old male rat pups were divided into six groups: normoxia control, normoxia EPO, hypoxia control, hypoxia EPO, HI control, and HI EPO group. Sham surgery or HI was performed in all animals. HI was induced by ligation of the right common carotid artery followed by 90 min of hypoxia with 8% oxygen. Recombinant human EPO 3 U/g or saline was administered intraperitoneally, immediately, at 24- and 48-hr after insult. At two weeks after insult, animals were challenged with cylinder-rearing test for evaluating forelimb asymmetry to determine sensorimotor function. All animals were then sacrificed for volumetric analysis of the cerebral hemispheres and the SVZ. The saline-treated HI rats showed marked asymmetry by preferential use of the non-impaired, ipsilateral paw in the cylinder-rearing test. Volumetric analysis of brains revealed significantly decreased preserved ipsilateral hemispheric volume and increased ipsilateral SVZ volume compared with the sham-operated animals. Treatment of EPO significantly improved forelimb asymmetry and preserved ipsilateral hemispheric volume along with decreased expansion of ipsilateral SVZ following HI compared to the saline-treated HI rats. These results support the use of EPO as a candidate drug for treatment of neonatal hypoxic-ischemic brain damage.
Animals ; Animals, Newborn ; Carotid Artery, Common ; Cerebral Ventricles/*pathology ; Erythropoietin, Recombinant/*pharmacology ; Female ; Hypoxia-Ischemia, Brain/*drug therapy/*pathology ; Ligation ; Male ; Motor Activity/drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Recovery of Function/drug effects

Background: Though antenatal magnesium sulfate (MgSO4 ) is widely used for fetal neuroprotection, suspicions about the long-term neuroprotection of antenatal MgSO4 have been raised. Methods: We investigated short- and long-term outcomes of antenatal MgSO4 use for 468 infants weighing < 1,500 g with a gestational age of 24–31 weeks. Results: Short-term morbidities and the risk of developmental delay, hearing loss, and cerebral palsy at a corrected age of 18–24 months and 3 years of age did not decrease in the MgSO4 group (infants who were exposed to MgSO4 for any purpose) or neuroprotection group (infants who were exposed to MgSO4 for fetal neuroprotection) compared with the control group (infants who were not exposed to MgSO4 ). The z-scores of weight, height, and head circumference did not increase in the MgSO4 group or neuroprotection group compared with the control group. Conclusion Antenatal MgSO4 including MgSO4 for neuroprotection did not have beneficial effects on long-term neurodevelopmental and growth outcomes.

PURPOSE: Granulocyte colony stimulating factor (G-CSF) has been known to increase neutrophil production and have anti-inflammatory properties, but the effect of G-CSF on pulmonary system is in controversy. We investigated whether G-CSF treatment could attenuate hyperoxia-induced lung injury, and whether this protective effect is mediated by the down-modulation of inflammatory responses in a neonatal rat model. MATERIALS AND METHODS: Newborn Sprague-Dawley rats (Orient Co., Seoul, Korea) were subjected to 14 days of hyperoxia (90% oxygen) beginning within 10 h after birth. G-CSF (20 microg/kg) was administered intraperitoneally on the fourth, fifth, and sixth postnatal days. RESULTS: This treatment significantly improved hyperoxia-induced reduction in body weight gain and lung pathology such as increased mean linear intercept, mean alveolar volume, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling positive cells. Hyperoxia-induced activation of nicotinamide adenine dinucleotide phosphate oxidase, which is responsible for superoxide anion production, as evidenced by upregulation and membrane translocation of p67phox was significantly attenuated after G-CSF treatment, as were inflammatory responses such as increased myeloperoxidase activity and mRNA expression of transforming growth factor-beta. However, the attenuation of other proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 was not significant. CONCLUSION: In sum, G-CSF treatment significantly attenuated hyperoxia-induced lung injury by down-modulating the inflammatory responses in neonatal rats.
Animals ; Animals, Newborn ; Blotting, Western ; Female ; Granulocyte Colony-Stimulating Factor/*therapeutic use ; Hyperoxia/*complications ; In Situ Nick-End Labeling ; Interleukin-6/genetics ; Lung/*drug effects/*metabolism ; Lung Injury/*drug therapy/etiology/genetics/metabolism ; NADPH Oxidase/metabolism ; Peroxidase/metabolism ; Pregnancy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta/genetics ; Tumor Necrosis Factor-alpha/genetics ; Weight Gain/drug effects

Atherosclerosis is a chronic progressive inflammatory disorder and the leading cause of cardiovascular mortality. Here we assessed the dynamic changes of T-cell-derived cytokines, such as inteferon (IFN)-gamma, interleukin (IL)-17 and IL-4, during the progression of atherosclerosis in apolipoprotein E-null (ApoE(-/-)) mice, to understand the role of immune responses in different stages of atherosclerosis. Male ApoE(-/-) mice were fed a high-fat, western-type diet (WD: 21% lipid, 1.5% cholesterol) after 5 weeks of age and were compared with C57BL/6 wild-type control mice fed a standard chow diet. Atherosclerotic lesions appeared in the aortic sinus of ApoE(-/-) mice 4 weeks after WD and the lesions progressed and occupied >50% of the total sinus area 16 weeks after WD. Aortic IL-17 mRNA and protein expression started to increase in ApoE(-/-) mice after 4 weeks on the WD and peaked at around 8-12 weeks on the WD. In terms of systemic expression of T-cell-derived cytokines, IL-17 production from splenocytes after anti-CD3/CD28 stimuli increased from 4 weeks on the WD, peaked at 12 weeks and returned to control levels at 16 weeks. The production of IFN-gamma and IL-4 (Th1 and Th2 cytokines, respectively) from splenocytes was delayed compared with IL-17. Taken together, the present data indicate that Th17 cell response may be involved at an early stage in the development of atherosclerosis.
Animals ; Aorta/metabolism/*pathology ; Apolipoproteins E/*genetics ; Atherosclerosis/etiology/*genetics/immunology/*pathology ; Diet, High-Fat/adverse effects ; Gene Deletion ; Interferon-gamma/genetics ; Interleukin-17/*genetics/immunology ; Male ; Mice, Inbred C57BL ; Mice, Knockout ; T-Lymphocytes/immunology/metabolism/pathology ; Up-Regulation

Atherosclerosis is a chronic progressive inflammatory disorder and the leading cause of cardiovascular mortality. Here we assessed the dynamic changes of T-cell-derived cytokines, such as inteferon (IFN)-gamma, interleukin (IL)-17 and IL-4, during the progression of atherosclerosis in apolipoprotein E-null (ApoE(-/-)) mice, to understand the role of immune responses in different stages of atherosclerosis. Male ApoE(-/-) mice were fed a high-fat, western-type diet (WD: 21% lipid, 1.5% cholesterol) after 5 weeks of age and were compared with C57BL/6 wild-type control mice fed a standard chow diet. Atherosclerotic lesions appeared in the aortic sinus of ApoE(-/-) mice 4 weeks after WD and the lesions progressed and occupied >50% of the total sinus area 16 weeks after WD. Aortic IL-17 mRNA and protein expression started to increase in ApoE(-/-) mice after 4 weeks on the WD and peaked at around 8-12 weeks on the WD. In terms of systemic expression of T-cell-derived cytokines, IL-17 production from splenocytes after anti-CD3/CD28 stimuli increased from 4 weeks on the WD, peaked at 12 weeks and returned to control levels at 16 weeks. The production of IFN-gamma and IL-4 (Th1 and Th2 cytokines, respectively) from splenocytes was delayed compared with IL-17. Taken together, the present data indicate that Th17 cell response may be involved at an early stage in the development of atherosclerosis.
Animals ; Aorta/metabolism/*pathology ; Apolipoproteins E/*genetics ; Atherosclerosis/etiology/*genetics/immunology/*pathology ; Diet, High-Fat/adverse effects ; Gene Deletion ; Interferon-gamma/genetics ; Interleukin-17/*genetics/immunology ; Male ; Mice, Inbred C57BL ; Mice, Knockout ; T-Lymphocytes/immunology/metabolism/pathology ; Up-Regulation

PURPOSE: This study was designed to review the clinical outcome of infants who underwent tracheostomy in the neonatal intensive care unit (NICU) of a single center in Korea during 16 years. METHODS: We retrospectively reviewed medical records of 33 patients who underwent tracheostomy in NICU of Samsung Medical Center between January, 1997 and December, 2013. We collected data on timing, indications, clinical outcomes, and complications of tracheostomy in the study patients. We also compared these variables with those in another single center study (study A) recently showing the outcome of infants who underwent tracheostomy in a NICU of USA during 10 years. RESULTS: The median gestational age and birth weight of the study patients were 35 weeks, and 3,200 g, respectively. Gestational age of the study patients was greater than that of study A (35 weeks vs. 27 weeks). The most common indication for tracheostomy was airway disease (69.7%) in our study. Bronchopulmonary dysplasia (9%) was less frequent indication for tracheostomy in our study when compared with in the study A (41%). Granuloma formation was the most common complication of tracheostomy (48%) and decannulation was accomplished in nine patients (27.3%). Although the mortality rate was 12.1%, no patient died from tracheostomy-related complications. CONCLUSION: Main causes of tracheostomy in our NICU are airway problems and neuromuscular diseases rather than bronchopulmonary dysplasia itself. For better clarification of clinical courses and outcomes related to tracheostomy performed in NICU in Korea, further study in a larger population will be needed.
Birth Weight ; Bronchopulmonary Dysplasia ; Gestational Age ; Granuloma ; Humans ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal* ; Korea ; Medical Records ; Mortality ; Neuromuscular Diseases ; Retrospective Studies ; Tracheostomy*

PURPOSE: To outline the aspects of extubation by birth weight and find the predictors for success/ failure at the first extubation in extremely low birth weight infants. METHODS: One hundred thirteen extremely low birth weight infants(< 1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. RESULTS: As the birth weight decreased, extubation success day was significantly delayed:16+/-3 day(d) in 900-999 g; 20+/-3 d in 800-899 g; 35+/-4 d in 700-799 g; 37+/-9 d in 600-699 g; 49+/-12 d in < or =599 g. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. CONCLUSION: We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.
Birth Weight* ; Body Weight ; Humans ; Incidence ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Membranes ; Mortality ; Nutritional Status ; Parturition* ; Rupture ; Seoul ; Sepsis ; Ventilators, Mechanical