BACKGROUND: Although postmenopausal estrogen replacement therapy is known to reduce cardiovascular mortality, the mechanism is not clear yet. Furthermore, the effect of estrogen on vascular tonus is reportedly variable according to the animal models, vascular beds and agonists used. MATERIALS AND METHOD: Bilateral ovariectomies were performed in 12 week-old, 18 spontaneously hypertensive rats (SHR) and 18 normotensive Wistar-Kyoto rats (WKY). Rats were divided into three groups according to the dose of 17beta-estradiol (E 2 ) pellets implanted subcutaneously two weeks after ovariectomy: control (no implantation), low-dose (0.5 mg) and high-dose (5 mg) E 2 replacement group. Two weeks after pellet implantation, organ bath experiments were performed using descending thoracic aortae. For endothelium-dependent relaxation, acetylcholine (10(-9) -3x10(-6) M) was cumulatively added into the vessels precontracted with 10(-7) M norepinephrine (NE). For vasoconstrictor responses, cumulative concentration-contraction curves were constructed in quiescent vessels using NE (10(-9) -10(-5) M), U46619 (10(-9) -3x10(-6) M), endothelin-1 (10(-10) -10(-7) M). In addition, contraction to angiotensin II (10(-7) M) was also obtained. Serum 17beta-estradiol levels were measured by radioimmunoassay. Blood pressure was measured by tail-cuff method in some SHRs before ovariectomy and after placebo/E 2 replacement. RESULTS: Endothelium-dependent relaxation to acetylcholine was impaired in WKY treated with 5 mg E 2 (pIC 50 : control vs 5mg E 2 : 7.75+/-0.13 vs 7.27+/-0.16: n=6: p<0.05). No significant effect was noted in SHR. Contraction to angiotensin II was inhibited by low-dose E 2 in WKY and high-dose E 2 in SHR (% of the contraction to 60 mM KCl: WKY: control vs 0.5 mg E 2 : 39+/-5 vs 25+/-2: SHR: control vs 5 mg E 2 : 34+/-4 vs 22+/-2: n=6 and p<0.05 in WKY and SHR). In contrast, NE-induced contraction was enhanced by E 2 replacement (both low- and high-dose) in WKY and SHR (WKY: control vs 0.5 mg E 2 vs 5 mg E 2 : AUC: 280+/-24 vs 387+/-26 vs 374+/-25: maximal contraction: 137+/-8 vs 166+/-8 vs 162+/-3: pD 2 : 7.63+/-0.11 vs 8.17+/-0.13 vs 8.13+/-0.13: SHR: control vs 0.5 mg E 2 vs 5 mg E 2 : AUC: 265+/-17 vs 349+/-16 vs 406+/-19: maximal contraction: 152+/-6 vs 181+/-9 vs 203+/-16: pD 2 : 7.45+/-0.13 vs 7.91+/-0.08 vs 8.04+/-0.04: n=6 and p<0.05 between control and treated groups in WKY and SHR for all parameters). Contraction to U46619 was enhanced by E 2 replacement in SHR (control vs 0.5 mg E 2 : AUC: 478+/-30 vs 574+/-23: maximal contraction: 181+/-9 vs 230+/-10: n=6: p<0.05 for both parameters). Maximal contractile response to endothelin-1 was also enhanced in SHR (control vs 0.5 mg E 2 vs 5 mg E 2 : maximal contraction: 165+/-7 vs 189+/-7 vs 199+/-8: n=6 and p<0.05 between control and treated groups) but not in WKY. Blood pressure was not different between placebo and E 2- treated SHR (171+/-2 vs 174+/-4 mmHg). CONCLUSION: In WKY, chronic high-dose estrogen replacement impairs endothelium-dependent relaxation to acetylcholine.: low-dose estrogen replacement does not affect endothelium-dependent relaxation in SHR and WKY. Estrogen replacement enhances the contraction to most of the contractile agonists tested except angiotensin II in both WKY and SHR. These results suggest that estrogen replacement affect the vascular tonus differently according to the vasoactive substances and/or hormones without significant effect on blood pressure.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Acetylcholine ; Angiotensin II ; Animals ; Aorta, Thoracic ; Area Under Curve ; Baths ; Blood Pressure ; Endothelin-1 ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Models, Animal ; Mortality ; Norepinephrine ; Ovariectomy ; Radioimmunoassay ; Rats ; Rats, Inbred SHR* ; Relaxation

Purpose: The purpose of our study is to examine early radiographic findings and clinical signs of failure of the microstructure surface HA-coated acetabular cup. Material and methods: This study included 41 revisions of 204 THA with hydroxyapatite-coated acetabular cup from April 1992 to November 1996. Radiolucent line around cups, change in the cup angle and osteolysis were evaluated in serial radiographs. Acetabular cup was defined as loosening if any movement occurred at the bone and socket interface by manual rotation and extension force intraoperatively or migration of more than 2 mm and change of the cup angle by more than 5 degrees in radiographs. Results: The radiolucent line was observed in 12 of the 41 hips at an average of 55.4 months postoperatively and was most commonly located in zone III. All of the 12 hips showing radiolucent lines were classified as loosening by radiographically in 8 cases and intraoperatively in 4 cases. Radiographic loosening occurred at an average of 28.8 months after the appearance of a radiolucent line. Inguinal pain was noted in 18 of the 19 cases revised for acetabular cup loosening. Conclusion: The most important radiographic finding for the early diagnosis of loosening was progressive radiolucent lines, which occurred most frequently in zone 3.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Early Diagnosis ; Hip ; Osteolysis

We reports a woman's death caused by massive intraabdominal hemorrhage, who was in chronic alcoholic state with advanced liver cirrhosis and found dead in her room. No macroscopic source for the bleeding was found in her intraabdomen and there was no circumstances of traumatic forces to the individual's body around the death. The presenting unsuspected death could be consistent with the forensic pathological cases described as sudden, unexpected death due to massive nontraumatic intraabdominal hemorrhage in association with liver cirrhosis by DiMaio in 1987.
Alcoholics ; Hemorrhage* ; Humans ; Liver Cirrhosis* ; Liver*

PURPOSE: This study was to evaluate the clinical results of the treatment of scaphoid nonunions using a pronator quadratus pedicled bone graft. METHODS: Thirteen patients with a scaphoid nonunion were treated with pronator quadratus pedicled bone graft. The average age of the patients was 20.23 years (range: 19-22 years) and the minimum follow-up period was one year. In all patients, bone grafting was performed and screw was fixed by using a volar aspect of distal radius bone graft with pronator quadratus muscle. RESULTS: All 13 patients showed radiographic union with the average union time of 10.8 weeks (range: 9-13 weeks). Flexion, extension, radial deviation and ulnar deviation of wrist joint improved compared to the preoperative condition (p<0.05). Postoperative scapholunate and radiolunate angle improved compared to the preoperative condition (p<0.05). Eleven patients (84.5%) showed excellent or good results according to Herbert and Fisher's score criteria of functional, subjective satisfaction and radiographic result. CONCLUSION: Pronator quadratus pedicled bone grafting can be considered to be easily accessible technique on vascularized bone graft for osteosynthesis of scaphoid nonunions. It is proved to be effective for bone union, increased wrist joint motion.
Bone Transplantation ; Follow-Up Studies ; Humans ; Radius ; Transplants ; Wrist Joint

Deep vein thrombosis (DVT) is a relatively common complication of total hip arthroplasty. DVT can accompany symptoms of pain and swelling of the lower leg, and can lead to fatal pulmonary thromboembolism. Surgical procedure is a primary risk factor, and obesity, medical status of disease, or patient's factors could be related. Diagnostic modalities include venography, Doppler ultrasound, CT angiography, and magnetic resonance venography. Mechanical prophylaxis, such as compression stocking and use of an intermittent pneumatic compression device or a pharmacological agent, such as Warfarin, low molecular weight heparin, thrombin inhibitors, and factor Xa inhibitor can be useful. Neurovascular injury after total hip arthroplasty is an uncommon complication, but can be disastrous and fatal. To prevent this complication, the surgeon must be well acquainted with the anatomy and proper surgical skill is needed.
Angiography ; Arthroplasty ; Factor Xa ; Heparin, Low-Molecular-Weight ; Hip ; Leg ; Magnetic Resonance Spectroscopy ; Obesity ; Phlebography ; Pulmonary Embolism ; Risk Factors ; Stockings, Compression ; Thrombin ; Venous Thrombosis ; Warfarin

PURPOSE: To explore clinical features and neurologic complications of pediatric enteroviral meningitis, and to evaluate risk factors according to the presence of cerebrospinal fluid (CSF) pleocytosis and neurologic complications. METHODS: Retrospective review of medical records of patients aged between 1 month and 18 years who were found positive for CSF enterovirus reverse transcription polymerase chain reaction in Dankook University Hospital from March 2009 to February 2015. RESULTS: A total of 151 children was enrolled in the study. Ninety four patients were males and the age at diagnosis was 40.9±47.0 months. Most common season of admission was summer (n=99, 65.6%). Most frequent presenting symptom was fever followed by poor oral intake, decreased activity, and headache. Fifty five (36.4%) patients had no CSF pleocytosis. Complications were observed in 4 (2.6%). Mean blood white blood cell, CSF protein levels were higher, and CSF glucose levels were lower in group with pleocytosis (P < 0.05). There were more seizure development and mental changes, higher peak body temperature, longer fever duration, and longer duration from symptom onset to CSF tapping in group with complications (P < 0.05). All were boys and mean age at admission was younger in group with complications, without statistically significant difference. CONCLUSION: Relatively high proportion of children with enteroviral meningitis showed no pleocytosis. Complications such as meningoencephalitis, refractory status epilepticus, or recurrent seizure rarely occurred, although most had good clinical outcomes.
Body Temperature ; Cerebrospinal Fluid ; Child ; Diagnosis ; Enterovirus ; Fever ; Glucose ; Headache ; Humans ; Leukocytes ; Leukocytosis ; Male ; Medical Records ; Meningitis* ; Meningoencephalitis ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcription ; Risk Factors ; Seasons ; Seizures ; Status Epilepticus

PURPOSE: The purpose of this study was to analysis the manuscripts rejected for publication in the Journal of Korean Academy of Nursing Administration during the last three years six months (2012~2015 Jun). METHODS: Seventy eight rejected manuscripts were analyzed focusing on manuscripts characteristics, such as rejection rates, year of submission, occupation of first author and corresponding author, number of authors, funding, thesis or dissertation, article type, study participants, number of reviews prior to rejection, and 3rd reviewer. Also reviewers' quantitative evaluation scores and subjective comments were analyzed. Reviewers' subjective comments were analyzed using content analysis methodology. RESULTS: The mean rate for manuscript rejection was 28.9% and for quantitative research, qualitative research, and review papers the quantitative evaluation scores were 2.54+/-0.70, 2.39+/-0.69, and 2.39+/-0.69 out of 5 points, respectively. The most frequent subjective comment on rejected manuscripts was 'lack of rationale for research need'. CONCLUSION: In this study the characteristics and the reasons for rejecting manuscripts were identified. These findings can be used in developing effective strategies for researchers, reviewers and editors to improve the quality of research and research reviews of nursing administration research.
Evaluation Studies as Topic ; Financial Management ; Manuscripts as Topic ; Nursing Administration Research ; Nursing Research ; Nursing* ; Occupations ; Peer Review ; Publications ; Qualitative Research

Vibrio vulnificus is a fatal marine Gram-negative bacillus that might cause septicemia, necrotizing cellulites in patients with underlying liver disease or an immunocompromised health status, and is associated with high mortality. It is usually attributed to the ingestion of raw shellfish or traumatic exposure to the marine environment. The clinical manifestation includes fever, chill, hypotension, and skin lesions such as erythematous patch, vesicle, bullae that develop into necrosis and wound infections. We report a case of Vibrio vulnificus septicemia and necrotizing fascitis in a patient who presented with septic arthritis of the knee as the first clinical manifestation.
Mortality

Posthypoxic myoclonus is poorly controlled with current treatments. Based on clinical experience, valproate and benzodiazepines have been used to treat myoclonic seizures. Rarely, some antiepileptic drugs may exacerbate myoclonic seizures. Although lamotrigine is controversial for treatment in myoclonic seizures, we experience a case of posthypoxic myoclonus improved with lamotrigine add-on therapy.
Anticonvulsants ; Benzodiazepines ; Myoclonus* ; Seizures ; Valproic Acid

A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxy-genation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
Adult ; Airway Obstruction ; Anemia, Aplastic ; Barotrauma* ; Bronchoscopy ; Emergencies ; Female ; Hemoptysis* ; Humans ; Mediastinal Emphysema ; Pneumothorax ; Subcutaneous Emphysema ; Ventilation* ; Ventilators, Mechanical