OBJECTIVETo study coronary artery stenosis, myocardial ischemia, and left ventricular dysfunction in dual source computed tomography (DSCT) coronary artery angiography.

METHODSTotally 32 patients underwent both DSCT and X-ray coronary angiography within one week to detect coronary artery stenosis separately. Meanwhile, the values of left ventricular myocardial mass (LVMM) , left ventricular ejection fraction (LVEF) , and left ventricular stroke volume (LVSV) were calculated using cardiac function software in DSCT. Electrocardiography was carried out to diagnose myocardial ischemia. The coronary artery stenosis, values of LVMM, LVEF, and LVSV, and myocardial ischemia were compared.

RESULTSThe results of DSCT and X-ray coronary angiography were not significantly different. LVMM, LVEF, LVSV, and myocardial ischemia were significantly different between two- or three-branch groups or between middle or severe groups (both P<0.05) . However, no such significant difference was observed between single and two branch groups and between mild and middle groups. There were no statistically different findings for LVEF and LVSV, but there was statistical deference between LVMM and myocardial ischemia (P<0.05) . For single branch and middle to severe stenosis in left anterior descending (LAD) coronary artery, right coronary artery, left circumflex coronary artery, only the values of LVMM,LVEF,and LVSV in LAD group showed significant difference (P<0.05) .

CONCLUSIONSMore stenotic branches and severer stenosis in coronary artery often are associated with higher incidence of myocardial ischemia and severer left ventricular dysfunction. The stenosis of LAD coronary artery has especially severe impact on cardiac functions. LVMM is a sensitive indicator for myocardial ischemia in coronary artery stenosis.

Aged ; Coronary Angiography ; methods ; Coronary Stenosis ; complications ; diagnostic imaging ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; etiology ; Tomography, X-Ray Computed ; methods ; Ventricular Function, Left ; physiology

Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.

Objective To discuss methods of decoration reconstruction for finger defect in emergency and to observe the elinical effects.Methods Of the 41 cases of finger injuries of different degrees,15 were repaired with part of the skin flaps of the big toenails or skin flaps of the second toenalis,8 were repaired with part of the skin flaps of the big toenails,7 were reeonstructed with the second tiptoes,11 were repaired with the abdominal skin flaps of the big toes or lateral flaps of the second toes.Results All the 41 fingers sur- vived.One skin flap of the big toe was somewhat swelling and a decorating operation was performed.The 4～18 months of follow-up visitation of the rest cases revealed good function and shapes.No obvious functional ab- norality was found in the donating feet.Conclusion Various kinds of decoration reeonstruetion for finger defects are available to recover the hand shape and function as much as possible.

AIMTo investigate the effect of capsaicin on IA and IK in cultured rat trigeminal ganglion (TG) neurons.

METHODSWhole-cell patch clamp technique was used to record the IA and IK before and after capsaicin perfusion at different concentrations.

RESULTSIn capsaicin-sensitive (CS) neurons, capsaicin was shown to selectively inhibit IA in dose-dependent manner, the IC50 was 0.99 micromol x L(-1). Yet capsaicin showed no inhibitory effect on IK, capsaicin (10 micromol x L(-1)) only slightly inhibited IK by 13.2%. In capsaicin-insensitive (CIS) neurons, capsaicin (1 micromol x L(-1)) showed no significant inhibitory effect on IA and IK, capsaicin (10 micromol x L(-1)) only slightly inhibited IA and IK by 16.8% and 15.3%, respectively. Neither 1 micromol x L(-1) nor 10 micromol x L(-1) capsaicin showed effect on the G-V curve of IA and IK.

CONCLUSIONCapsaicin was found to selectively inhibit the IA current in CS neurons, and this effect may contribute to hyperalgesia when capsaicin was first used.

Animals ; Capsaicin ; pharmacology ; Cells, Cultured ; Female ; Male ; Neurons ; physiology ; Patch-Clamp Techniques ; Potassium Channels, Voltage-Gated ; drug effects ; Rats ; Rats, Sprague-Dawley ; Trigeminal Ganglion ; cytology ; physiology

PURPOSE: This study aimed to inquire into the educational implication of peer evaluation in PBL in relation to the evaluation system. METHODS: 89 third and fourth-year medical students in PBL courses participated in this study. Descriptive statistics analysis and correlation analysis were performed. RESULTS: Based on the results of the interviews with all the forth-year students, the feedback method of peer evaluation was modified and the peer evaluation sheet was revised. On the new peer evaluation system, the percentages of indiscriminant scores were significantly lower than those on the previous system. Peer evaluation on the new evaluation system was positively related to tutor evaluation, written examination, and quizzes. Correlations between the peer evaluation scores each units were higher than those of the tutor evaluation scores. All third-year students within the bottom ten percent on the peer evaluation score failed to successfully complete that year. CONCLUSION: The peer evaluation with feedback based on faculty counseling and a user-friendly evaluation sheet can be used as an effective method for assessing student performance in PBL and to screen for maladjusted students.
Counseling ; Humans ; Problem-Based Learning* ; Students, Medical

PURPOSE: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. METHODS: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. RESULTS: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. CONCLUSION: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.
Accidental Falls* ; Dizziness ; Gait ; Hearing ; Humans ; Inpatients* ; Leg ; Length of Stay ; Logistic Models ; Nursing Records ; Patient Safety ; Risk Assessment ; Risk Factors* ; Seoul ; Tertiary Care Centers* ; Urination ; Vasodilator Agents ; Walking

OBJECTIVETobacco smoking results in increased platelet aggregability, which suggests that low-dose aspirin used in common clinical practice may not effectively inhibit platelet activity in smokers with coronary heart disease (CHD). This review was performed to assess the effect of aspirin on platelet aggregation in patients with CHD.

DATA SOURCESWe performed an electronic literature search of MEDLINE (starting from the beginning to March 15, 2009) using the term "smoking" or "tobacco" paired with the following: "platelet", "aspirin" or "coronary heart disease".

STUDY SELECTIONWe looked for review articles regarding the effect of tobacco smoking on platelet activity and on the anti-platelet efficacy of aspirin in healthy people and patients with CHD. The search was limited in "core clinical journal". In total, 1321 relevant articles were retrieved, and 36 articles were ultimately cited.

RESULTSTobacco smoking results in increased platelet aggregability, which can be inhibited by low-dose aspirin in the healthy population. However, in patients with CHD, the increased platelet aggregability can not be effectively inhibited by the same low-dose of aspirin. A recent study indicated that clopidogrel or an increased dose of aspirin can effectively inhibit the increased platelet aggregability induced by tobacco smoking in patients with CHD.

CONCLUSIONSIt is important for patients with CHD to quit smoking. For the current smoker, it may be necessary to take larger doses of aspirin than normal or take an adenosine diphosphate receptor inhibitor along with aspirin to effectively inhibit the increased platelet activity.

Aspirin ; therapeutic use ; Coronary Disease ; drug therapy ; Drug Interactions ; Humans ; Platelet Aggregation Inhibitors ; therapeutic use ; Smoking ; adverse effects

OBJECTIVETo develop a mouse model of acute lung injury induced by cigarette smoke (CS) and to investigate inflammatory changes with the model.

METHODSICR mice exposed to CS for 20-min, 3/d. Bronchoalveolar lavage fluid (BALF) and lung tissue were harvested at d 0, d 1, d 3 and d 7 after CS exposure. Neutrophil count in BAFL, TNF-alpha and MMP-12 levels, the activity of MPO in lung tissue were determined.

RESULTNeutrophil count in BALF, MMP-12 and MPO levels in lung tissue were increased after CS exposure in a time-dependent manner with a peak at d3. TNF-alpha level sharply increased at d1, and remained high level until d7.

CONCLUSIONICR mice are tolerant and sensitive to CS exposure, which may be used as an appropriate animal model for acute lung injury induced by cigarette smoke.

Acute Lung Injury ; chemically induced ; pathology ; Animals ; Bronchoalveolar Lavage Fluid ; cytology ; Disease Models, Animal ; Male ; Matrix Metalloproteinase 12 ; metabolism ; Mice ; Mice, Inbred ICR ; Smoke ; adverse effects ; Tobacco ; adverse effects ; Tumor Necrosis Factor-alpha ; metabolism

Malignant mixed mullerian tumor of the ovary are very aggressive tumors that were usually diagnosed at an older age. They are usually at an advanced stage at the time of diagnosis, and survival after diagnosis varies by stage of disease and histological type. Despite aggressive treatment that includes surgery and chemotherapy, women with these tumors have a significantly increased risk of death giving them a very poor prognosis. The poor prognosis associated with this rare disease represents a need to new therapeutic regimens to improve patients' survival. We experienced two cases of primary malignant mixed mullerian tumor of the ovary.
Diagnosis ; Drug Therapy ; Female ; Humans ; Ovary* ; Prognosis ; Rare Diseases

PURPOSE: This study was aimed to examine whether tutor evaluation in the PBL course assesses different aspects of learning from what written examination assesses. METHODS: 89 medical students were assessed by Self-Directed Learning Readiness Scale (SDLRS) and Learning Orientation Scale (LOS) in March 2004. Their tutor evaluation and written examination scores in the 1st semester of 2004 PBL units were collected in August 2004. Data analyses were conducted using t-test, correlation analysis, and linear regression. RESULTS: SDLRS scores were significantly correlated with tutor evaluation scores, but not with written examination scores. Both schoolwork orientation and academic orientation scores on LOS were significantly associated with tutor evaluation and written examination scores. Tutor evaluation scores were explained significantly by all predictors, such as SDLRS, schoolwork orientation, and academic orientation scores. However, written examination scores were explained significantly by academic orientation only. CONCLUSIONS: Tutor evaluation in the PBL assessed student self-directed learning readiness and academic orientation, but written examination did not. The findings show a crucial possibility that tutor evaluation may overcome shortcomings of the written examination.
Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Learning* ; Linear Models ; Problem-Based Learning ; Psychological Tests ; Regression Analysis ; Statistics as Topic ; Students, Medical