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Clinical Efficacy and Hormonal Change of GnRH Antagonist in Controlled Ovarian Stimulation for IVF-ET (체외수정시술을 위한 과배란유도에 있어 GnRH Antagonist의 임상적 효용성과 혈중 호르몬 농도의 변화)

  • Moon, Shin-Yong;Chun, Eun-Kyung;Kim, Sang-Don;Choi, Young-Sik;Jee, Byung-Chul;Ku, Seung-Yup;Suh, Chang-Suk;Choi, Young-Min;Kim, Jung-Gu;Kim, Seok-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.4
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    • pp.225-234
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    • 2004
  • Objectives: To evaluate the efficacy of GnRH antagonist cetrorelix in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to determine changes in serum hormone concentrations during cetrorelix administration. Methods: We performed a clinical trial on 30 patients undergoing COH with highly purified follicular stimulating hormone (HP-FSH) and gonadotropin releasing hormone antagonist (GnRHant), cetrorelix. FSH was administrated from day 2 or 3 of cycle with fixed dose and adjusted according to individual response. 0.25 mg of cetrorelix was injected daily subcutaneously from stimulation day 5 until the day of hCG administration. Daily ultrasound monitoring was performed for growing follicles and serum levels of luteinizing hormone (LH), estradiol ($E_2$) and progesterone were measured daily during cetrorelix administration. Up to 4 embryos were transferred. Results: Mean age of enrolled patients was $32.0{\pm}3.4$ years (mean $\pm$ S.D.). All of 30 patients underwent oocyte pick-up, and embryo transfer was done in 28 patients. The total and mean numbers of received oocytes were 196 and $6.5{\pm}4.7$, the number of fertilized eggs was 111, and the fertilization rate was 56.6%. Total duration of FSH administration was $9.2{\pm}2.2$ days and mean of $24.3{\pm}7.7$ ampules of HP-FSH was administered. Total duration of cetrorelix administration was $5.7{\pm}1.9$ days. Serum LH and progesterone levels were maintained in the range of $1.4{\sim}2.9\;mIU/mL$ and $0.3{\sim}0.6\;ng/mL$, which respectively reflected effective prevention of premature LH surge. Clinical pregnancies were achieved in 9 patients, and overall clinical pregnancy rate was 30.0% per oocyte retrieval, and 32.1% per embryo transfer. Conclusion: GnRH antagonist is safe and convenient for COH for IVF-ET and effective with optimal pregnancy rate.

Cost-Benefit Analysis of Back School Program for Occupational Low Back Pain Patients (직업성 요통환자에서 재활 프로그램(Back School Program) 도입의 비용-편익분석)

  • Ju, Yeong-Su;Ha, Mi-Na;Han, Sang-Hwan;Kwon, Ho-Jang;Cho, Soo-Hun;Kim, Chang-Yup;Kim, Sun-Min
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.347-357
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    • 1996
  • Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

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ABO and Rh Blood Groups and Risk of Colorectal Adenocarcinoma

  • Urun, Yuksel;Ozdemir, Nuriye Yildirim;Utkan, Gungor;Akbulut, Hakan;Savas, Berna;Oksuzoglu, Berna;Oztuna, Derya Gokmen;Dogan, Izzet;Yalcin, Bulent;Senler, Filiz Cay;Onur, Handan;Demirkazik, Ahmet;Zengin, Nurullah;Icli, Fikri
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6097-6100
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    • 2012
  • Background: Previous studies have observed an association between ABO blood group and risk for certain gastrointestinal malignancies, including pancreatic and gastric cancer. However, it is unclear whether there is such an association with colorectal cancer (CRC). In this study, possible relationships between ABO blood groups and Rh factor and KRAS status in patients with CRC were investigated. Materials and Methods: In 1,620 patients with CRC, blood group and Rh factor were examined and compared with the control group of 3,022,883 healthy volunteer blood donors of the Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with wild type K-ras status was also evaluated. Results: Overall distributions of ABO blood groups as well as Rh factor were comparable between patients (45% A, 7.2% AB, 16.4% B, 31.4% O, and 87.2% Rh+) and controls (42.2% A, 7.6% AB, 16.3% B, 33.9% O, and 87.7% Rh+) (p=0.099). However, there were statistically significant difference between patients and controls with respect to O vs. non O blood group (p=0.033) and marginally significant difference for A vs. non-A blood group (p=0.052). Among patients, the median age was 62 (range 17-97), 58.1% were male. There were no statistically significant differences respect to sex and K-ras status. Conclusion: In present study, the ABO/Rh blood groups were statistically significantly associated with the risk of CRC. There were no relationship between K-ras status and ABO blood group and Rh factor. However further studies with larger numbers of patients are needed to establish the role of blood groups and to define t he mechanisms by which ABO blood type affect CRC.

A study on the Image of Nurses and Determinants the Image (간호사이미지 결정요인에 관한 연구)

  • Yang, Il-Shim
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.289-306
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    • 1998
  • For continuous development of professional nursing to the powerful professional organization, it is essential that the public understand and help nursing. This research was done to identify the image of nurses and factors that determine that image. The study subjects were 97 admitted patients 95 family members of patients who were admitted to a university hospital and a general hospital in Seoul and 164 parents of stutents in elemantary, middle, high schools in Seoul. The total numbers of subjects was 356. The researcher collected the data from April 13.1998 to April 20.1998. The Research tool was developed by the researcher following a literature review. Cronbach ${\alpha}$ for the tool of the image of nurses was 0.9397 and Cronbach a for the tool for determinants of the image was 0.8764. The obtained data were processed by SPSS (Statistical Package for Social Science) and the results are as follows : 1. The mean score for the image of nurses was 90.40${\pm}$15.15(range 47${\sim}$138) indicating a positive response. 2. Analysis of the image of nurses : Four factors were identified traditional. social. professional and personal image. The mean score for traditional image was 3.27. the second highest score. and for social image. 2.95. the lowest score. The mean score for professional image score was 3.48. the highest score. and for personal image, 3.20. a lower score. 3. The image of nurses according to respondents There were significant differences for traditional. social, professional. personal factors between subject groups. A more positive responses was found in the patients and patient' families as a compared to the students' parents. 4. Image of nurses related general characteristics : There was a significant difference for age and school graduation. More negative responses were found in the 31${\sim}$40 years old age group and in the higher educated group. 5. Image of nurses related to experience of nurses The respondents showed a more negative image when their experience related to nurses through the mass media, as a compared to the experiences of having talked with patient who had been admitted to hospital. For the social image factor. a more negative attitude was revealed for those who had the experience of patient who had been admitted to hospital as compared to other factors. 6. Determinants of image of nurses : There were three factors that were named subjective. administrative and media . The mean for the subjective factor score was 3.85. the highest score of the three factors. The mean for the administrative factor score was 3.53. And the mean for the media factor score was 3.27. 7. Determinants of image of nurses according to respondents group : There were no significant differences(F= 1.95, P= .14) Consequently the result showed a low social image of nurses. So. nurses must work to improve the social image of nurses through scientific approaches and by monitoring the mass media for correct descriptions of nurses. Also. it is necessary that excellent education for service and politeness be continually provided in order to positively effect the personal image field. It is also importent to raise the expectations of the recipients of nursing care by having a strategy for the determinants of the image of nurses that allows nurses to personnally develop professionally.

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The Factors Causing Change of Lifestyle by the Outcome of Oriental Medical Examination (한방건강검진(韓方建康檢診) 결과(結果)에 따른 생활행동(生活行動) 변화(變化)에 영향(影響)을 미치는 요인(要因))

  • Na Sam-Sik;Kwon So-Hui;Seo Ji-Yeon;Jung Hae-Kyoung;Kim Yoo-Chul;Song Yung-Sun;Jang Du-Seop;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.139-150
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    • 2003
  • This study tried to know the chang of lifestyle and the factors causing of lifestyle change by the outcome of oriental medical examination for labors in one of the automobile factories in Jeon Buk area. The results will be helpful to the effective health care for the labors in factory. Oriental medical examination was done 22 times from May 20 to June 19, 2002. The numbers of labor who received oriental medical examination were 531, and 300 questionnaires among them were collected. The results were as follows: 1) General characteristics of examinee for oriental medical examination; total 300 labors, high percentage in age range $31{\sim}45$ years old, mostly married, high percentage of high school in completion of study. High percentages in drinking, smoking, and working hour were less than 1 time per week, non-smoking, and above 10 hours, respectively. High percentages in working year and salary were $11{\sim}15$ years. 2) The degree of lifestyle change by the oriental medical examination had the highest score with consult of oriental medicine doctor, and the lowest score was from moire typography result. 3) The degree of lifestyle change by medical examination was highly influenced by the subject characteristics that were less than 1 time per week for drinking, non-smoking, and less than 10 years of working year. 4) For the lifestyle change by the cognition of subject, the subjects who had high confidence for oriental medical examination, high recognition for oriental medical examination's requirement, high concern for health. effective cognition for early detection of disease, had high degree of lifestyle change. 5) The variables that cause lifestyle change in Sasang constitutional analysis result were early detection of disease, type of smoking, working year, moire typography result, interview for health. The variables that cause lifestyle change in moire typography result were type of drinking, ages, working year, consult for health, moire typography result. The variables that cause lifestyle change in interview with oriental medicine doctor were constitutional analysis and moire typography result.

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Effect of SSEx on the Metabolic Syndrome in High-Fat Diet Induced Obese Mice (소풍순기원(疏風順氣元)이 고지방식이 비만 대사증후군 병태 흰쥐에 미치는 효과)

  • Kim, Bo-Kyung;Oh, Young-Jin;Chun, Young-Ho;Ha, Ji-Won;Lee, Hee-Young;Jeong, Hae-Gyeong;Shin, Soon-Shik;Lee, Sang-Eon
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.53-68
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    • 2010
  • Objectives : We investigated the effects of Sopungsungj-won(Shufengshunqjvuan) (SSEx1, SSEx2) on the metabolic syndrome in high-fat diet induced obese mice. Methods: 8 weeks old, high fat diet induced obese male mice were divided into 4 groups: C57BL/6 lean control, obese vehicle control, SSEx1, SSEx2. After mice were treated with SSExl, SSEx2 for 12 weeks, we measured body weight gain, food intake, feeding efficiency ratio, fat weight, plasma leptin, insulin, glucose and lipid levels. We also observe the morphology and count for the numbers of Adipocyte and evaluate the weight of organs and it's function. Results: 1. Compared to Obese Control Group, SSEx1 gained significantly lower body weight and showed lower Feeding Efficiency Ratio. 2. Compared to Obese Control Group, SSEx1 showed lower weights of epididymal adipose tissue, troperitoneal adipose tissue, inguinal adipose tissue, brown adipose tissue. SSEx2 showed higher weights of epididymal adipose tissue, troperitoneal adipose tissue, inguinal adipose tissue, brown adipose tissue. 3. Compared to Obese Control Group, the size of adipocytes was significantly decreased by SSEx1, whereas the number of adipocites per unit was significantly increased. Hepatic lipid accumulation was decreased significantly by SSEx1. 4. Concerning the weights of Liver, Heart, Spleen, Kidney and Pancreas, SSEx1, SSEx2 showed little differences with those of Lean Control, Obese Control. 5. Compared to Obese Control Group, SSEX1, SSEx2 showed lower level of plasma triglyceride, but SSEx1 had significance only. SSEx1, SSEx2 showed little lower level of plasma HDL-cholesterol. LDL-cholesterol, total cholesterol, but had no significances. 6. Concerning the levels of plasma glucose, insulin and leptin, SSEx1 and SSEx2 showed littele changes with those of Lean Control, Obese Control. 7. The leves of Plasma AST, AST, ALT, free fatty acid, BUN, creatinine were in the physiological range at 4 groups all: Lean Control, Obese Control, SSEx1, SSEx2. Conclusions : These results showed SSEx1 can be used as therapeutic agent for Obesity and metabolic syndrome caused by long-period high fat diet.

Anticancer and Immunopotentiating Activities of Crude Polysaccharides from Pleurotus nebrodensis on Mouse Sarcoma 180

  • Cha, Youn Jeong;Alam, Nuhu;Lee, Jae Seong;Lee, Kyung Rim;Shim, Mi Ja;Lee, Min Woong;Kim, Hye Young;Shin, Pyung Gyun;Cheong, Jong Chun;Yoo, Young Bok;Lee, Tae Soo
    • Mycobiology
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    • v.40 no.4
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    • pp.236-243
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    • 2012
  • Pleurotus nebrodensis is an edible and commercially available mushroom in Korea. This study was conducted in order to evaluate the anticancer and immunopotentiating activities of crude polysaccharides, extracted in methanol, neutral saline, and hot water (hereafter referred to as Fr. MeOH, Fr. NaCl, and Fr. HW, respectively) from the fruiting bodies of P. nebrodensis. ${\beta}$-Glucan and protein contents in Fr. MeOH, Fr. NaCl, and Fr. HW extracts of P. nebrodensis ranged from 23.79~36.63 g/100 g and 4.45~6.12 g/100 g, respectively. Crude polysaccharides were not cytotoxic against sarcoma 180, HT-29, NIH3T3, and RAW 264.7 cell lines at a range of $10{\sim}2,000{\mu}g/mL$. Intraperitoneal injection with crude polysaccharides resulted in a life prolongation effect of 11.76~27.06% in mice previously inoculated with sarcoma 180. Treatment with Fr. NaCl resulted in an increase in the numbers of spleen cells by 1.49 fold at the concentration of $50{\mu}g/mL$, compared with control. Fr. HW improved the immuno-potentiating activity of B lymphocytes through an increase in alkaline phosphatase activity by 1.65 fold, compared with control at $200{\mu}g/mL$. Maximum production of nitric oxide ($14.3{\mu}M$) was recorded in the Fr. NaCl fraction at $200{\mu}g/mL$. Production of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-$1{\beta}$), and interleukin-6 (IL-6) was significantly higher, compared to control, and IL-6 production was highest, in contrast to TNF-${\alpha}$, IL-$1{\beta}$, and positive control, concanavalin at the tested concentration of the various fractions. Results of the current study suggest that polysaccharides extracted from P. nebrodensis have a strong anticancer effect and may be useful as an ingredient of biopharmaceutical products for treatment of cancer.

Effects of Worksite Nutrition Counseling for Health Promotion; Twelve-Weeks of Nutrition Counseling Has Positive Effect on Metabolic Syndrome Risk Factors in Male Workers (직장인 남성을 대상으로 한 12주간의 영양교육이 대사증후군 관련 인자에 미치는 영향)

  • Lee, Mi-Sun;Kang, Hae-Jin;Oh, Hye-Sun;Paek, Yun-Mi;Choue, Ryo-Won;Park, Yoo-Kyoung;Choi, Tae-In
    • Korean Journal of Community Nutrition
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    • v.13 no.1
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    • pp.46-61
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    • 2008
  • The purpose of this study was to investigate the effect of nutrition counseling on improving metabolic syndrome (MS) risk factors. Sixty-eight subjects were grouped according to their numbers of MS risk factors. Subjects who have three or more risk factors of MS were defined as "High risk", subjects who have two risk factors of MS were defined as "low risk", and subjects who have below two risk factors of MS were defined as "no risk" group. All groups finished nutrition counseling every three weeks for 12 weeks. Anthropometric, dietary assessments (24 hr-recall) and blood samples were measured at 0 and 12 weeks nutrition counseling. After 12 weeks of intervention, anthropometric data (weight, BMl, body fat (%), and waist/hip ratio) were significantly decreased (p < 0.05) in all groups. Daily consumption of calorie was decreased significantly (p < 0.05) in the group of low risk and high risk. Blood level of fasting plasma glucose was significantly decreased (p < 0.001) in all groups after 12 weeks of intervention. Significantly, the fasting plasma glucose level was returned to normal range in the high risk group. The number of people who have three or more risk factors of MS (high risk group) was decreased from 25 to 12. Sum of MS Criteria decreased from 85 to 52 in the group of MS and decreased from 143 to 99 in all groups. These results indicate that nutrition counseling for male workers at the worksite proved to be helpful by reducing the risk factors of MS and thereby reducing the risk of cardiovascular disease. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites.

Uncertainty, Self-Efficacy & Coping in Parents′ of Children with Cancer (암환아 부모의 질병에 대한 불확실성, 자기효능감 및 대처정도)

  • Oh Won Oak;Park Eun Sook
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.274-285
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    • 1998
  • Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.

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A COMPARATIVE STUDY ON THE STRENGTH AND THE BONE FORMATION AT THE RATS CALVARIAL DEFECTS OF DFDB GRAFT AND THOSE OF THE COMPOSITE GRAFT WITH DFDB AND RESORBABLE HYDROXYAPATITE (백서 두개골 결손부에 동결 건조 동종 탈회골을 단일매식한 경우와 동결 건조 동종 탈회골과 흡수성 수산화인회석을 복합매식한 경우의 강도 및 골형성에 관한 비교 연구)

  • Seo, Young-Ho;Yim, Chang-Joon;Lee, Jae-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.557-564
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    • 2000
  • The bone graft materials can be grossly divided into autogenous bone, allogenic bone, xenogenic bone, and alloplastic material. Much care was given to other bone graft materials away from autogenous bone due to its additional operation for harvesting, delayed resorption and limitation of quantity. Demineralized freeze-dried bone(DFDB) and hydroxyapatite are the representatives of bone graft materials. As resorbable hydroxyapatite is developed in these days, the disadvantage of nonresorbability can be overcome. So we planned to study on the strength and the bone formation at the rats calvarial defects of DFDB graft and those of the composite graft with DFDB and resorbable hydroxyapatite. We used the 16 male rats weighting range from 250 to 300 gram bred under the same environment during same period. After we made the 6mm diameter calvarial defect, we filled the DFDB in 8 rats and DFDB and resorbable hydroxyapatite in another 8 rats. We sacrificed them at the postoperative 1 month and 2 months with the periostium observed. As soon as the specimens were delivered, we measured the compressive forces to break the normal calvarial area and the newly formed bone in calvarial defect area using Instron(Model Autograph $S-2000^{(R)}$, Shimadzu, Japan). The rest of the specimens were stained with H&E(Hematoxylin & Eosin) and evaluated with the light microscope. So we got the following results. 1. In every rats, there was no significant difference between the measured forces of normal bone area and those of the bone graft area. 2. In 1 month, the measured forces at DFDB graft group were higher than those of the DFDB and resorbable hydroxyapatite composite graft group(P<0.05). 3. In 2 months, there was no significant differences between the measured forces of DFDB graft group and those of the DFDB and resorbable hydroxyapatite composite graft group. 4. In lightmicroscopic examination, most of the grafted DFDB were transformed into bone in 1 month and a large numbers of hydroxyapatite crystal were observed in DFDB and resorbable hydroxyapatite composite graft group in 1 month. 5. Both group showed no inflammatory reaction in 1 month. And hydroxyapatite crystals had a tight junction without soft tissue invagination when consolidated with newly formed bone. 6. In both groups, newly formed bone showed the partial bone remodeling and the lamellar bone structures and some of reversal lines were observed in 2 months. From the above results, it is suggested that DFDB and resorbable hydroxyapatite composite graft group had a better resistance to compressive force in early stage than DFDB graft group, but there would be no significant difference between two groups after some period. And it is suggested that the early stage of bone formation procedure of DFDB and resorbable hydroxyapatite composite graft group was slight slower than that of DFDB graft group, but there would be no significant difference between two groups after some period.

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