Association between a Missense Polymorphism (rs3924999, Arg253Gln) of Neuregulin 1 and Schizophrenia in Korean Population

Neuregulin 1 (NRG1) is associated with the pathogenesis of schizophrenia through controlling activation and signaling of neurotransmitter receptors. Influence to schizophrenia development by the NRG1 gene may differ in individuals, and genetic polymorphism is one of the factors affecting their differences. Association between three single nucleotide polymorphisms (SNPs) (rs7014762, -1174 A/T; rs11998176, -788 A/T; rs3924999, Arg253Gln) of NRG1 and the development of schizophrenia was analyzed in 221 schizophrneia and 359 control subjects. Polymerase chain reaction and direct sequencing were performed to obtain genotype data of NRG1 SNPs of the subjects. In analysis of genetic data, multiple logistic regression models (codominant1, codominant2, dominant, recessive, and log-additive model) were applied. SNPStats and SPSS 18.0 were used to calculate odds ratio (OR), 95% confidence interval (CI), and p-value of each model. The genotype distributions of rs3924999 were associated with schizophrenia development (OR=0.67, 95% CI=0.47-0.95, p=0.022 in the dominant model and OR=0.69, 95% CI=0.51-0.93, p=0.013 in the log-addtive model) and allelic distributions also showed significant association (OR=0.70, 95% CI=0.52-0.93, p=0.014). The results suggest that rs3924999 of the NRG1 gene may be associated with schizophrenia susceptibility.

A Case of Adrenocortical Carcinoma Secreting Cortisol, Androgen and Aldosterone

Primary adrenocortical carcinoma is a rare tumor, and is characterized by a peri-tumor mass effect and hormone excess signs. Adrenocortical carcinoma most commonly secretes cortisol, but tumors that secrete other adrenal hormones (aldosterone, androgen) are rare. Herein, we report the case of a 70-year-old woman with cortisol, androgen, and aldosterone-secreting adrenal carcinoma. The patient complained of generalized weakness, moon face, and central obesity. On laboratory examination, hypokalemia and metabolic alkalosis was detected. On the hormone test, cortisol, DHEA-S, and aldosterone were all increased. Abdominal CT showed a large right adrenal mass. She underwent right adrenalectomy and the histology revealed the presence of an adrenocortical carcinoma. After adrenalectomy, the patient was treated with hydrocortisone and mitotane.

Critical Thinking Disposition and Problem Solving Ability in Nursing Students / 간호행정학회지

PURPOSE: This study was done to identify the relationship between critical thinking disposition and problem solving ability in nursing students, thereby providing basic data for nursing education. METHOD: A convenience sample was drawn from 161 nursing students. Data were collected from June 2008 to October 2008. Instruments used in the study were the California Critical Thinking Disposition Inventory (CCTDI) developed by Facione & Facione (1992) and the Problem Solving Inventory (PSI) developed by Heppner & Petersen (1982). The collected data were analyzed using t-test, ANOVA, Scheffe' test, Pearson correlation coefficients and multiple regression with SPSS 12.0. RESULTS: The total mean score for CCTDI was 278.41 and PSI was 119.23. For general characteristics, there were statistically significant differences in CCTDI according to satisfaction with nursing majors (F=6.29, p=.00) and PSI according to academic achievement (F=3.45, p=.02) and marital status (t=2.43, p=.02). A statistically significant negative correlation was found between CCTDI and PSI. Critical thinking self-confidence, Analyticity and Inquisitiveness were significant predictors of PSI. CONCLUSION: The findings of this study indicate that critical thinking disposition influences problem solving ability. Therefore, the findings provide significant basic data for nursing education and nursing practice.

Effects of Transobturator Adjustable Tape Sling Procedure on the Therapeutic Outcome in Patients with Stress Urinary Incontinence and Detrusor Underactivity / 대한배뇨장애요실금학회지

PURPOSE: To evaluate the outcome and efficacy of transobturator adjustable (TOA) tape sling operations on women with intrinsic sphincter deficiency (ISD) and/or detrusor underactivity (DU) combined with stress urinary incontinence (SUI). MATERIALS AND METHODS: This retrospective analysis comprised 60 TOA patients. 30 patients hadDU (Qmax < 15ml/s) and/or ISD (Valsalva leak point pressure;VLPP < 60cmH20) on the preoperative UDS and the rest only had SUI. I-QoL, visual analog scale (VAS), Patient's Perception of Urgency Severity (PPUS), and Self-Assessment/Sandvik Questions were performed before and 1 year after surgery. The mesh tension was controlled at 1 day after surgery. The objective cure rate was defined as no leakage using the cough test with a full bladder. RESULTS: Patients were divided into two groups: Group A:SUI with ISD and/or DU, n=30; Group B:only SUI without ISD and DU, n=30. The two groups showed a difference in Qmax and VLPP preoperatively. Objective success rates were 18 (60.0%) completely cured, 10 (33.3%) improved in Group A, and 23 (76.7%) completely cured, 7 (23.3%) improved in Group B. Three cases needed tape-tension adjustment due to urinary leakage one-day after surgery (2 in Group A, 1 in Group B). There was no postoperative urinary retention. CONCLUSIONS: After TOA for SUI with ISD and/or DU, 3 cases were needed tension adjustment after surgery. TOA procedures seem to be effective and safe, more clinical studies with long-term follow up are required for a definite conclusion.

The Effect of Posterior Colporrhaphy Performed Concurrently with Midurethral Sling Surgery on the Sexual Function of Women with Stress Urinary Incontinence / 대한배뇨장애요실금학회지

PURPOSE: Some women choose to undergo posterior colporrhaphy (PC) concurrently with procedures for SUI to regain sexual confidence and improve sexual function. We determine the effect of PC on sexual function in women requiring a midurethral sling for SUI. MATERIALS AND METHODS: A total of 119 women were retrospectively reviewed 81 women had the midurethral sling alone (Group A), and 38 women voluntarily had PC concurrently with the midurethral sling (Group B). Sexual function was evaluated using the FSFI before and after surgery. RESULTS: The postoperative composite scores were significantly increased in both groups (Group A: p=0.02; Group B: p=0.04), and significant increases were observed in 'desire,' 'arousal' and 'satisfaction'. However, there were no significant differences in the composite score or six domainscores between the two groups. CONCLUSION: PC performed concurrently with midurethral sling for treatment of SUI does not provide any additional benefits towards improving the sexual function.

The pNNx Heart Rate Variability Statistics: An Application to Neuroautonomic Dysfunction of Clozapine-Treated Subjects

OBJECTIVE: The percentage of successive normal cardiac interbeat intervals greater than 50 msec (pNN50) is a widely used heart rate variability measure, which is useful in identifying the neuroautonomic dysfunction of psychiatric disorders. However, pNN50 is only one member of a larger family of pNNx statistics, where x is greater than 0 msec. The potential application of the general pNNx statistics has not yet been explored in the psychiatric field. The authors examined the pNNx statistics in clozapine-treated subjects and normal controls to evaluate the usefulness of the general pNNx statistics. METHODS: Sixty-one schizophrenic patients treated with clozapine and fifty-nine normal controls were evaluated. Probability values for the differences between the groups at each pNN value (range: pNN1-pNN100) were calculated using data obtained from a 30-minute electrocardiogram. RESULTS: The conventional pNN50 and pNNx values with x<50 msec were all significantly lower in the patient group (p<0.05). The distinction between the two groups was more prominent at pNN values less than 50 msec than that observed at pNN50. The maximum separation between groups occurred at pNN5 (68.2+/-19.1 vs. 22.5+/-20.5, p<10(-22)). CONCLUSION: The pNNx with x<50 msec provided more robust discrimination between the groups than the conventional pNN50, suggesting the importance of analyzing very small variations of interbeat interval in discriminating normal and pathological heart rate patterns. The results also suggest that the general pNNx statistics may be applied and useful in evaluating the neuroautonomic dysfunction in patients treated with clozapine, complementing the traditionally computed pNN50 value.

The pNNx Heart Rate Variability Statistics: An Application to Neuroautonomic Dysfunction of Clozapine-Treated Subjects

OBJECTIVE: The percentage of successive normal cardiac interbeat intervals greater than 50 msec (pNN50) is a widely used heart rate variability measure, which is useful in identifying the neuroautonomic dysfunction of psychiatric disorders. However, pNN50 is only one member of a larger family of pNNx statistics, where x is greater than 0 msec. The potential application of the general pNNx statistics has not yet been explored in the psychiatric field. The authors examined the pNNx statistics in clozapine-treated subjects and normal controls to evaluate the usefulness of the general pNNx statistics. METHODS: Sixty-one schizophrenic patients treated with clozapine and fifty-nine normal controls were evaluated. Probability values for the differences between the groups at each pNN value (range: pNN1-pNN100) were calculated using data obtained from a 30-minute electrocardiogram. RESULTS: The conventional pNN50 and pNNx values with x<50 msec were all significantly lower in the patient group (p<0.05). The distinction between the two groups was more prominent at pNN values less than 50 msec than that observed at pNN50. The maximum separation between groups occurred at pNN5 (68.2+/-19.1 vs. 22.5+/-20.5, p<10(-22)). CONCLUSION: The pNNx with x<50 msec provided more robust discrimination between the groups than the conventional pNN50, suggesting the importance of analyzing very small variations of interbeat interval in discriminating normal and pathological heart rate patterns. The results also suggest that the general pNNx statistics may be applied and useful in evaluating the neuroautonomic dysfunction in patients treated with clozapine, complementing the traditionally computed pNN50 value.

The Experience of Mind Control among Elderly in Korea / 성인간호학회지

PURPOSE: This study was conducted to understand the meaning of mind control as it is understood by elderly persons in Korea. METHOD: This study was conducted by engaging three elderly persons who are over the age of sixty five and presently residing in Seoul. Several in depth interviews were conducted with these individuals from March 2003 until November 2003. The contents of the interviews were analyzed using the Giorgi Method (1985), which places the emphasis on discovering meaning within the phenomenological context of an individual's experience. RESULTS: The analysis of the contents revealed the following four components with regard to the meaning of mind control for elderly persons (1) Settling the mind (2) Gradual lowering of expectations and hope for the success of offspring, (3) Having good thoughts and acting accordingly, and (4) Making up one's mind to follow the 'natural flow of life'. CONCLUSION: By allowing a wider and deeper understanding of the meaning of mind control for elderly persons the results of this study provide a basis for improving the care of elderly with a holistic perspective.

A Study on the Urinary Incontinence, Lower Urinary Tract Symptoms, Lifestyle and Sexual Matters of Women in an Urban Area / 성인간호학회지

PURPOSE: The purpose of this study was to identify the frequency of urinary incontinence and lower urinary symptoms, to identify lifestyle and sexual matters for UI of adult women in an urban area. METHOD: The sample consisted of 364 educated women from a women's health education program in a public health center. For data collection, the Bristol Female Lower Urinary Tract Symptoms Questionnaire developed by Jackson, et. al.(1996) and the demographic questionnaire were used. For data analysis, SAS 8.2 program was used. RESULT: The results were as follows: 1. the prevalence rate of UI was 73.63%. 45.88% of them were stress incontinence and 27.75% of them were urge incontinence. 2. Remarkable differences were found between the type of UI and LUTS in the case of urgency(x2=42.0585, P<0.001), unexplained incontinence(x2=59.0585, P<0.001), noctural incontinence(x2=18.8080, P<0.001) and catetherization(x2=10.7207, P= 0.004), burning sense(x2=27.7400, P<0.001). 3. Remarkable differences were found between the type of UI and lifestyle matters in the cases as follows fluid intake restriction(x2=31.0532, P=0.008), interference in physical activity(x2= 36.7481, P=0.001), interference in relation with others(x2=22.2729, P=0.034). 4. Remarkable differences were found between the type of UI and sexual matters with difficulty of sexual intercourse(x2=16.1898, P=0.002), and urine leakage during sexual intercourse(x2=17.9752, P=0.001). CONCLUSION: Based on the results, developing and carrying out an adequate UI care and education program is needed.

A Study on the Critical Thinking Disposition about Student Nurse / 성인간호학회지

PURPOSE: This descriptive - comparison study was conducted to investigate the critical thinking disposition of senior nursing students in three types of nursing program. Method: The convenience sample was drawn from 472 nursing students. Instruments used in this study were made California Critical Thinking Disposition Inventory developed by Facione & Facione (1994). Data was analyzed by descriptive statistics, t-test, ANOVA, Scheffe test with SAS 6.12 program. RESULTS: 1. The total mean score of critical thinking disposition was 279.06. Inquisitiveness was the highest with an mean score 45.50, while systematicity was the lowest with mean score of 36.15. There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00)according to senior nursing students in three types of nursing programs. 2. There was a statistically significant difference in critical thinking disposition(F=5.53, p=.00) according to age, marital status(t=-3.15, p=.00), religion(F=3.26, p=.02) and critical thinking course taken previously(t=3.10, p=.00). CONCLUSION: There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00) according to senior nursing students in three types of nursing program. There was a statistically significant difference in Critical thinking disposition according to age, marital status, religion, logic, philosophy, critical thinking course.

A Study on the Critical Thinking Disposition about Student Nurse / 성인간호학회지

PURPOSE: This descriptive - comparison study was conducted to investigate the critical thinking disposition of senior nursing students in three types of nursing program. Method: The convenience sample was drawn from 472 nursing students. Instruments used in this study were made California Critical Thinking Disposition Inventory developed by Facione & Facione (1994). Data was analyzed by descriptive statistics, t-test, ANOVA, Scheffe test with SAS 6.12 program. RESULTS: 1. The total mean score of critical thinking disposition was 279.06. Inquisitiveness was the highest with an mean score 45.50, while systematicity was the lowest with mean score of 36.15. There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00)according to senior nursing students in three types of nursing programs. 2. There was a statistically significant difference in critical thinking disposition(F=5.53, p=.00) according to age, marital status(t=-3.15, p=.00), religion(F=3.26, p=.02) and critical thinking course taken previously(t=3.10, p=.00). CONCLUSION: There was a statistically significant difference in critical thinking disposition(F=14.36, p=.00) according to senior nursing students in three types of nursing program. There was a statistically significant difference in Critical thinking disposition according to age, marital status, religion, logic, philosophy, critical thinking course.

A Study of Women's Menopausal Experiences / 간호학회지

This study was alone to identify the meaning and the essence of the menopause experience by means of the Colaizzi's phenomenological method. The participants were eight women, 48-60 years old, who were experiencing perimenopause or postmenopause. They were selected using a theoretical sampling technique. Data were collected through in-depth interviews from April 6 to May 20, 1999. The interviews took from 40 to 90 minutes. Interviews were tape- recorded and analyzed using the constant comparative method. Significant statements from data were extracted. From these formulated meanings, 18 themes, 8 clusters of themes and 3 catagories were constructed. Final descriptions were found to be valid through the interviewee validation process. Essential themes of the menopausal experience which emerged were "coming of change", "inclined to deny the in mind", and "adapted life". Menopause, as coming of change was the turning point in the women's life cycle acompaning changes, in body and mind and marital life changes. Especially, the unpredictable menopausal changes were an opportunity to hide the fact of menopause and not to talk with anybody. Such a phenomenon reflected on the psychological attributes of menopausal woman such as an inclination to deny in the mind. Their experiences of menopause as adapted life were generally regarded as signalling the end of fertility and were interpreted as a natural developmental process that indicates a life transition. In conclusion, participants depicted the menopause as a natural stage in the life cycle. In order to help women have a positive life change and self accomplishment, nurses need to understand the essential themes of the menopausal experience. Thus, the importance of an open approach in eliciting the phenomena of menopause cannot be overemphasized. In conclusion, the results of this study suggest that exercise program is one of the effective interventions to improve the self-efficacy and also to lower the fatigue in the sample of female college students.