Treatment Sequence After Initiating Biologic Therapy for Patients With Rheumatoid Arthritis in Korea: A Nationwide Retrospective Cohort Study

Objective@#To evaluate treatment patterns and healthcare resource utilization (HCRU) after initiating biologic disease-modifying antirheumatic drugs (bDMARDs) in Korean patients with rheumatoid arthritis (RA). @*Methods@#Patients newly diagnosed with RA in 2014 were identified and followed up on using the Korean National Health Insurance Database until 2018. The initial line of therapy (LOT) or LOT1 included patients treated with conventional DMARDs (cDMARD). Patients who started a bDMARD were assigned to LOT2 bDMARD. Those who moved from a bDMARD to a Janus kinase inhibitor were assigned to LOT3. Analyzed outcomes were treatment patterns and HCRU in LOT2 bDMARD. @*Results@#The most prescribed initial bDMARD was a tumor necrosis factor inhibitor. Seventy-five percent of patients had changes in treatment after starting a bDMARD, such as addition/removal or switch of a DMARD, and transition to LOT3. For the first and second changes in LOT2 bDMARD, adding a cDMARD to a bDMARD was more common than switching to another bDMARD (7.98% vs. 2.93% for the first change, and 17.10% vs. 6.51% for the second change). Tocilizumab was the most common bDMARD that was switched to. Forty-eight percent of patients had at least one hospitalization after initiating bDMARDs. Of these patients, 64.3% were admitted due to RA-related reasons. @*Conclusion@#This real-world study provides information on treatment characteristics of RA patients in Korea after starting a bDMARD. In contrary to guidelines, cDMARD addition was more often than bDMARD switches in daily clinical practice.

Human Endogenous Retroviruses: Friends and Foes in Urology Clinics / 대한배뇨장애요실금학회지

Human endogenous retroviruses (HERVs) are originated from ancient exogenous retroviruses, which infected human germ line cells millions of years ago. HERVs have generally lost their replication and retrotransposition abilities, but adopted physiological roles in human biology. Though mostly inactive, HERVs can be reactivated by internal and external factors such as inflammations and environmental conditions. Their aberrant expression can participate in various human malignancies with complex etiology. This review describes the features and functions of HERVs in urological subjects, such as urological cancers and human reproduction. It provides the current knowledge of the HERVs and useful insights helping practice in urology clinics.

Biocompatibility and Bioactivity of Four Different Root Canal Sealers in Osteoblastic Cell Line MC3T3-El / 치위생과학회지

Background@#Endodontic sealers or their toxic components may become inflamed and lead to delayed wound healing when in direct contact with periapical tissues over an extended period. Moreover, an overfilled sealer can directly interact with adjacent tissues and may cause immediate necrosis or further resorption. Therefore, the treatment outcome conceivably depends on the endodontic sealer’s biocompatibility and osteogenic potential. This study aimed to evaluate the cell viability and osteogenic effects of four different sealers in osteoblastic cells. @*Methods@#AH Plus (resin-based sealer), Pulp Canal Sealer EWT (zinc oxide-eugenol sealer), BioRoot RCS (calcium silicate-based sealer), and Well-Root ST (MTA-based calcium silicate sealer) were mixed strictly according to the manufacturer’s instructions, and dilutions of sealer extracts (1/2, 1/5 and 1/10) were determined. Cell viability was measured using the water-soluble tetrazolium-8 (WST-8) assay. Differentiation was assessed by alkaline phosphatase (ALP) activity and mineralized nodule formation by Alizarin Red S staining. @*Results@#The cell viability of the extracts derived from the sealers excluding Well-Root ST was concentration dependent, with sealer extracts having the least viability at a 1/2 dilution. At sealer extract dilution of 1/10, the test groups showed the same survival rate as that control group, with the exception of BioRoot RCS. Among all experimental groups, BioRoot RCS showed the highest cell viability after 48 hours. The ALP activity was significantly higher in a concentration-dependent manner. Furthemore, all four materials promoted ALP activity and mineralized nodule formation compared to the control at 1/10 dilutions. @*Conclusion@#This is the first study to highlight the differences in biological activity of these four materials. These results suggest that the composition of root canal sealers appears to alter the form of biocompatibility and osteoblastic differentiation.

Risk of Coronavirus Disease 2019 Occurrence, Severe Presentation, and Mortality in Patients with Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to analyze whether patients with lung cancer have a higher susceptibility of coronavirus disease 2019 (COVID-19), severe presentation, and higher mortality than those without lung cancer. @*Materials and Methods@#A nationwide cohort of confirmed COVID-19 (n=8,070) between January 1, 2020, and May 30, 2020, and a 1:15 age-, sex-, and residence-matched cohort (n=121,050) were constructed. A nested case-control study was performed to compare the proportion of patients with lung cancer between the COVID-19 cohort and the matched cohort. @*Results@#The proportion of patients with lung cancer was significantly higher in the COVID-19 cohort (0.5% [37/8,070]) than in the matched cohort (0.3% [325/121,050]) (p=0.002). The adjusted odds ratio [OR] of having lung cancer was significantly higher in the COVID-19 cohort than in the matched cohort (adjusted OR, 1.51; 95% confidence interval [CI], 1.05 to 2.10). Among patients in the COVID-19 cohort, compared to patients without lung cancer, those with lung cancer were more likely to have severe COVID-19 (54.1% vs. 13.2%, p < 0.001), including mortality (18.9% vs. 2.8%, p < 0.001). The adjusted OR for the occurrence of severe COVID-19 in patients with lung cancer relative to those without lung cancer was 2.24 (95% CI, 1.08 to 4.74). @*Conclusion@#The risk of COVID-19 occurrence and severe presentation, including mortality, may be higher in patients with lung cancer than in those without lung cancer.

Risk of Coronavirus Disease 2019 Occurrence, Severe Presentation, and Mortality in Patients with Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to analyze whether patients with lung cancer have a higher susceptibility of coronavirus disease 2019 (COVID-19), severe presentation, and higher mortality than those without lung cancer. @*Materials and Methods@#A nationwide cohort of confirmed COVID-19 (n=8,070) between January 1, 2020, and May 30, 2020, and a 1:15 age-, sex-, and residence-matched cohort (n=121,050) were constructed. A nested case-control study was performed to compare the proportion of patients with lung cancer between the COVID-19 cohort and the matched cohort. @*Results@#The proportion of patients with lung cancer was significantly higher in the COVID-19 cohort (0.5% [37/8,070]) than in the matched cohort (0.3% [325/121,050]) (p=0.002). The adjusted odds ratio [OR] of having lung cancer was significantly higher in the COVID-19 cohort than in the matched cohort (adjusted OR, 1.51; 95% confidence interval [CI], 1.05 to 2.10). Among patients in the COVID-19 cohort, compared to patients without lung cancer, those with lung cancer were more likely to have severe COVID-19 (54.1% vs. 13.2%, p < 0.001), including mortality (18.9% vs. 2.8%, p < 0.001). The adjusted OR for the occurrence of severe COVID-19 in patients with lung cancer relative to those without lung cancer was 2.24 (95% CI, 1.08 to 4.74). @*Conclusion@#The risk of COVID-19 occurrence and severe presentation, including mortality, may be higher in patients with lung cancer than in those without lung cancer.

Effect of Nutritional Intervention by the Nutrition Support Team on Postnatal Growth in Preterm Infants

Purpose@#Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). @*Methods@#Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. @*Results@#The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. @*Conclusion@#The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

Effect of Nutritional Intervention by the Nutrition Support Team on Postnatal Growth in Preterm Infants

Purpose@#Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). @*Methods@#Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. @*Results@#The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. @*Conclusion@#The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

Lymphoepithelioma-like carcinoma of the uterine cervix

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is exceedingly uncommon. We herein report a rare case of cervical LELC. A 45-year-old woman was admitted to gynecology department with vaginal bleeding for one month. Liquid-based cytology revealed atypical endometrial cells, not otherwise specified on her cervix. On a hysteroscopy, an endocervical mass was identified and the pathologic result was consistent with poorly differentiated squamous cell carcinoma. Magnetic resonance imaging and positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography revealed a 3.1-cm endocervical mass without distant metastasis or enlarged lymph nodes. The International Federation of Gynecology and Obstetrics stage was IB1. A radical hysterectomy and bilateral pelvic lymph node dissection were performed. The pathologic diagnosis was a poorly differentiated carcinoma, showing features of LELC. She has been followed for 8 months without adjuvant treatment since the surgery, during which time there has been no evidence of tumor recurrence or metastasis.

Extrauterine epithelioid trophoblastic tumor in hysterectomized woman

Epithelioid trophoblastic tumor (ETT) is a very rare variant of gestational trophoblastic disease (GTD) which arises in reproductive age women with prior gestational history. Although abnormal vaginal bleeding is the most common symptom of ETT, there are no reported pathognomonic symptoms of ETT because of its rarity. ETT is similar to placental site trophoblastic tumor in terms of its slow growing characteristic and microscopic findings. Therefore, it could be misdiagnosed as placental site trophoblastic tumor or other types of GTD. Unlike other types of GTD, primary treatment of ETT is surgical resection because of its chemo-resistant nature. Accordingly, immunohistochemical staining is essential for accurate diagnosis and appropriate treatment. Here, we report a case of a 42-year-old hysterectomized woman with pelvic masses who suffered from abdominal pain. Through laparotomy, tumors were resected completely and they were diagnosed as ETT through immunohistochemical stain. This report provides more evidence about its clinical features, diagnosis, and treatment including a brief review of the literature.

Relationships among Menstrual Attitude, Premenstrual Distress, and Premenstrual Coping in Korean College Women

PURPOSE: This paper presented a descriptive study which aimed to identify the relationship among menstrual attitude, premenstrual distress and premenstrual coping in Korean college women and to propose fundamental data for the development of guidelines for effective management of premenstrual distress. METHODS: The data were collected from 111 college women and analyzed using descriptive statistics, t-tests, ANOVA and Pearson's correlation coefficients. RESULTS: The mean score of premenstrual coping was 3.25±0.60 out of 5 points. The ‘Awareness and Acceptance of Premenstrual Change’ score was highest and the ‘Avoiding Harm’ score was lowest. Menstrual attitude was significantly related to premenstrual distress (r=.37 p<.001) and the awareness and acceptance style of premenstrual coping (r=-.21. p=.021). And premenstrual distress was significantly related to the self-care coping style of premenstrual coping (r=.30, p=.001), the adjusting energy coping style of premenstrual coping (r=.45, p<.001) and the avoiding harm coping style of premenstrual coping (r=.48, p<.001). CONCLUSION: Results of this study support that positive attitude about menstruation is necessary for the effective management of premenstrual distress. Also, premenstrual coping programs that consider the level of premenstrual distress will be needed for college women.

Non-puerperal Uterine Inversion Presented with Hypovolemic Shock

We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status. Pathologic report confirmed benign submucosal fibroid with degeneration, necrosis and abscess formation. Thus, clinician should be aware of uterine inversion when encountered with huge protruding vaginal mass and consider uterus-preserving management as surgical option when the future fertility is concerned.

Association between Chronic Mental Stress and Academic Performance among Korean Adolescents / Asociación entre estrés mental crónico y desempeño académico en adolescentes koreanos

En este estudio se examinó si el estrés mental crónico se asocia con el rendimiento académico en adolescentes coreanos. La muestra estuvo constituida por los 74.186 adolescentes de entre el 7 y el 12 ° grado (12-18 años) que participaron en la 8va encuesta en internet sobre Comportamiento de Riesgo en Jóvenes en 2012. Se utilizó el análisis de regresión logística multivariante para aclarar cómo el estrés crónico mental se relacionaba con el rendimiento académico después del ajuste por edad, índice de masa corporal, posición económica de la familia, el nivel de educación de los padres, la frecuencia de fumar, la frecuencia de ingesta de alcohol, y la frecuencia de la actividad física vigorosa y moderada y ejercicios de fuerza musculares. Para los varones, las personas con estrés mental crónico muy alto tenían menos probabilidades de lograr un rendimiento académico promedio o superior (odds ratio [OR] = 0.738, 95% intervalo de confianza [IC]: 0.629 a 0.867, p <0,001) que aquellos con muy estrés mental baja. Para las niñas, las que tenían estrés mental muy alto tenían menos probabilidades (OR = 0.668; IC del 95%: 0.521 - 0.857, p = 0.002), mientras que aquellas con estrés mental bajo tenían más probabilidades (OR IC = 1.324, 95%: 1.029 -1.704; p = 0.029) para tener un rendimiento promedio académico o superior, en comparación con las niñas con estrés muy bajo. Los grados (pruebas, exámenes de ingreso) fueron la principal causa de estrés mental crónico tanto en varones (51.7%) y niñas (54.,8%). Los varones y las niñas de la República de Corea de estrés mental crónico muy alto mostraron una disminución del rendimiento académico.

We examined whether chronic mental stress is associated with academic performance in Korean adolescents. Our sample consisted of the 74,186 adolescents between the 7th and 12th grades (aged 12-18 years) who participated in the 8th Korean Youth Risk Behavior Web-based Survey in 2012. We used multivariate logistic regression analysis to clarify how chronic mental stress was related to academic performance after adjustment for age, body mass index, family economic status, parents' education level, smoking frequency, alcohol intake frequency, and frequency of vigorous and moderate physical activity and muscular strength exercises. For boys, those with very high chronic mental stress were less likely to achieve average academic performance or higher (odds ratio [OR] = 0.738, 95% confidence interval [CI]: 0.629-0.867, p < 0.001) than were those with very low mental stress. For girls, those with very high mental stress were less likely (OR = 0.668, 95% CI: 0.521-0.857, p = 0.002), while those with low mental stress were more likely (OR = 1.324, 95% CI: 1.029-1.704; p = 0.029) to have average academic performance or hig-her, compared with girls with very low stress. Grades (tests, entrance examinations) were the primary cause of chronic mental stress in both boys (51.7%) and girls (54.8%). Republic of Korean boys and girls with very high chronic mental stress showed decreased academic performance.

Validating of the pre-clinical mouse model for metastatic breast cancer to the mandible

Metastatic breast carcinoma has a great tendency to spread to the mandible. It is concomitantly associated with bone destruction, food intake disorder, and a poorer prognosis. Appropriate animal models need to be developed for a better understanding of the mechanisms underlying the metastatic process of breast cancer cells to mandible and to test the effects of potential lead compounds. Here, we assessed the metastasis model of intracardiac injection using luciferase-transfected metastatic breast cancer cells (MDA-MB-231Luc+) by determining the incidences of metastasis, mCT images, and histopathological results. A high bioluminescence signal mainly detected mandibular lesions with less frequent distal femora and proximal tibiae lesions. Extensive mandibular bone destruction occurred in nude mice grafted with metastatic breast cancer cells. This type of animal model might be a useful tool in assessing therapeutic implications and the efficacy of anti-cancer drugs for osteolytic cancers.

The Relationship between Uric Acid and Homocysteine Levels based on Alcohol-related Facial Flushing

BACKGROUND: This study aimed to determine the correlation between blood uric acid and homocysteine levels, based on alcohol-related facial flushing. METHODS: Among male adults who visited a health examination center of a university hospital located in Daejeon, Korea, for a personal health examination from March 2013 to February 2014, 702 subjects were analyzed including 401 subjects without alcohol-related facial flushing and 301 with facial flushing. Pearson's correlation and stepwise multivariate linear regression analyses were performed between the log homocysteine levels and other variables including uric acid. RESULTS: Uric acid showed a significant positive correlation with log homocysteine (gamma=0.166, P=0.001) (beta=0.176; P=0.001) in the non-flushing group. In contrast, none of the variables showed any significant correlations with log homocysteine in the flushing group. CONCLUSIONS: Alcohol users not exhibiting alcohol-related facial flushing showed a positive correlation between uric acid and homocysteine levels, whereas those without facial flushing showed no such correlation.

Effects of Clinical Practice and Simulation-Based Practice for Obstetrical Nursing

PURPOSE: The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress. METHODS: A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks. RESULTS: The experimental group showed higher level of self-efficacy (p=.043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group. CONCLUSION: Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.

Prediction of an actual birth within one week by ultrasonographic examination at 38 weeks' of gestation / 대한산부인과학회지

OBJECTIVE: The aim of this study is to predict spontaneous labor onset delivery within 7 days in low risk pregnant women at 38 weeks' of gestation by ultrasonographic examination of cervical changes. MATERIAL AND METHODS: This prospective study included 110 singleton low risk pregnancies between 37(+0) and 37(+6) weeks of gestation. Fifteen cases were lost during follow-up and finally 95 pregnant women (58 nulliparous, 37 multiparous) were analysed. The study period was from Oct/2005 to May/2007. Four cervical changes (length, gland thickness, funneling and canal formation) were evaluated. Main outcome was remaining day to delivery after the examination. Remaining days to actual delivery with spontaneous labor onset were recorded and the pregnancies were divided into two groups according to remaining days (within 7 days, over 7 days) to compare predicting power of delivery within 7 days. ROC curves were drawn to find out cut-off values of cervical length and gland thickness. Sensitivity, specificity, positive predictive value and negative predictive value were extracted from four cervical changes. RESULTS: Mean cervical length of pregnant women at 38 weeks' of gestation was 25.8 (+/-10.0) mm and mean cervical gland thickness was 4.3 (+/-1.2) mm. Funnelings of uterine cervix were detected in 13 cases (13.7%), canal formations in 6 cases (6.3%). All four cervical changes were statistically valuable to predict delivery within 7 days and the cervical length showed highest sensitivity. When the cervical length was measured under 20 mm, the possibility of delivery within 7 days was 78.6% (p<0.001). The cervical gland thickness less than 4 mm could predict the delivery within 7 days with sensitivity of 57.1% (p<0.01). Sensitivities of funneling and canal formation for delivery within 7 days were 54.5%, 36.4% each. CONCLUSION: Ultrasonographic examination of the cervical changes in low risk singleton pregnancy at 38 weeks' of gestation are valuable for predicting spontaneous labor onset delivery within 7 days. Among four cervical changes, cervical length is most sensitive ultrasonographic marker.

Effects of Quetiapine on the Immobilization Stress-induced BDNF and CRF Expression in Rat Brain / 대한정신약물학회지

OBJECTIVE: In this study we examined the effects of quetiapine on the immobilization stress-induced brain-derived neurotrophic factor (BDNF) and corticotropin-releasing factor (CRF) expression in rat brain. We also assessed the antidepressant activity of quetiapine. METHOD: We used in situ hybridization to examine the effects of chronic administration of quetiapine in gene transcription. This study also examined the influence of quetiapine in an animal model of depression, the forced swimming test (FST). RESULTS: 1) Repeated immobilization stress (2 hr daily for 3 weeks) decreased mRNA levels of BDNF in the hippocampus (p<0.01), parietal cortex (p<0.01) and pyriform cortex (p<0.05). 2) Repeated immobilization stress increased mRNA levels of CRF in the hypothalamic paraventricular nucleus (PVN)(p<0.01). 3) Chronic quetiapine (10 mg/kg) treatment (daily for 3 weeks) alone significantly increased BDNF mRNA expression in the dentate gyrus of hippocampus when compared to controls under basal conditions (p<0.01), whereas no such effect was observed in the neocortex. 4) Chronic pretreatment of quetiapine also markedly increased the stress-induced decrease of BDNF mRNA expression in the hippocampus (p<0.01) and neocortex (p<0.01). 5) Moreover, the stress-induced elevation of CRF mRNA expression was blocked by chronic quetiapine pretreatment in PVN (p<0.01) although chronic quetiapine treatment alone did not significantly reduce CRF mRNA levels in comparison to controls under basal condition. 6) When rats received acutely quetiapine, quetiapine did reduce the immobility time at 10 mg/kg, as compared with the control group (p<0.05). CONCLUSION : These results suggest that quetiapine has not only potentially an antidepressant effect but also a neuroprotective action in schizophrenia and this effect may be related to its antipsychotic effect in patients with schizophrenia.

Elevated Expression of p73 and Its Relation to VEGF and TSP-1 Production in Cervical Carcinoma / 대한산부인과학회지

OBJECTIVE: Measure the over-expression of p73 and analyze as the prognostic as well as angiogenic factor of cervical cancer by comparing the degree of expression of VEGF and TSP-1 by RT-PCR. METHODS: 7 normal and 37 cervical cancer specimens were put through RT-PCR and the expression of p73, VEGF and TSP-1 were measured. After immunohistochemical staining, the number of microvessels was counted. With the level of expression, investigated the relationship with the clinicopathological characteristics and the number of microvessels. RESULTS: 57% of cancer tissues showed abnormally high levels of p73 mRNA. In quantitative genomic DNA PCR, the p73 was over-expressed in the transcription level. Through allotyping with Sty I polymorphism, the over-expression of p73 was due to the transcription activity of the silent allele. In RT-PCR-SSCP analysis of over-expressed specimens, sequence alterations was not seen. In 73%, VEGF was over-expressed while TSP-1 was under-expressed in 35%. There was no association between the number of microvessels with the over-expression of p73 and VEGF, but inversely associated with the under-expression of TSP-1. There was no correlation between the over-expression of p73 and the clinicopathological characteristics. The over-expression of p73 coincided 80% with the over-expression of VEGF, and 40% with the under-expression of TSP-1. CONCLUSION: These data support the expression of p73 was increased in cervical cancer tissues and was associated with the over-expression of the VEGF but not associated with the under-expression of TSP-1. The biological and clinical significance of the over-expression of p73 should be studied further in the future.

Effect of Providing Information on Anxiety, Knowledge and Compliance of Patients with a Permanent Pacemaker / 성인간호학회지

PURPOSE: This study was undertaken to identify the effect of providing information on anxiety, knowledge and compliance in permanent pacemaker patients. METHOD: A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 50 patients who had received permanent pacemaker implantation at a university hospital in Seoul. They were divided into an experimental group of 22 patients who received education and a control group of 28 patients. The education was composed of group education(twice) and individualized reinforcement education(once) using an education booklet. RESULTS: Anxiety decreased in the experimental group. Knowledge significantly increased in the experimental group compared to that in the control group. Compliance significantly increased in the experimental group. CONCLUSION: It can be concluded that providing information is effective for reducing anxiety, increasing knowledge and improving compliance of the permanent pacemaker patients.

The Effect on Pain of Waiting between Paracervical Block and Procedure in Dilatation and Curettage / 대한산부인과학회잡지

OBJECTIVE: In Korea, approximately 600 thousand artificial abortions are done officially during the course of a year, and dilatation and curettage is commonly used as a method for selective abortion. In addition, because of the increasing use of hormone replacement therapy for treating postmenopausal syndrome and for the diagnostic purposes for postmenopausal bleeding, the importance of dilatation and curettage is emphasized more and more. Our objective was to verify the effects of delayed time between paracervical block and the procedure of dilatation and curettage on pain and patient satisfaction. METHODS: 92 women who underwent dilatation and curettage were picked and divided into 2 groups randomly. In group A there was no transit delay time between paracervical block and the procedure, and in group B, there was 5 minutes delay time. We used the VAS (Visual Analogue Scale) to measure numerical value of pain and patient satisfaction during uterine cervical dilatation, the actual procedure of curettage, and 30-45 minutes after the procedure. RESULTS: There was no statistically meaningful difference on the pain value and patient satisfaction between group A and group B measured during uterine cervix dilatation, curettage, and 30-45 minutes after the procedure. CONCLUSION: The transit delay time between paracervial anesthesia and dilatation and curettage had no specific effects on the pain or patient satisfaction of the procedure. Therefore, the main role of paracervical anesthesia is not to block the peripheral nerve, but instead to dilatate the tissue mechanically.