The Prescribing Patterns of Antipsychotic Drugs and Antiparkinsonian Drugs in Elderly Patients with Dementia

Background@#The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. @*Methods@#We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. @*Results@#Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. @*Conclusions@#Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

Proposal of Pharmacy School Objective Structured Clinical Examination (OSCE) Contents and Test Methods

Competencies of entry-level pharmacists are evaluated by multiple-choice questions (MCQ) examination and objective structured clinical examination (OSCE). OSCE helps to evaluate student’s communication skills and attitudes, which are difficult to evaluate by the MCQ exam. In Korea, pharmacy OSCE is not implemented; however, the needs of OSCE is growing. This study proposed OSCE exam contents and exam methods that can be implemented in colleges of pharmacy. Further study is needed to develop OSCE scenarios and questions, validate examination questions and evaluation methods by performing a pilot study, and provide feedback on the curriculum and study methods.

Development of Agenda for Pharmaceutical Care Service Research and Development using the Analytical Hierarchy Process

BACKGROUND: Although the importance of pharmaceutical care service has been growing to meet the needs of customers with the improvement of clinical and humanistic outcomes, there was not a systematic strategy to promote research in Korea. The aim of this study was to suggest the core agendas for pharmaceutical care services research and development (R&D) considering priorities. METHODS: Based on desk researches, we developed R&D agendas for the needs of improving pharmaceutical care services in the area of institution, community, and public health. To determine the priority of agendas in developing pharmaceutical care service, analytic hierarchy process (AHP) analysis was performed by the 14 experts. Criteria and subcriteria were assessed for significance by pairwise comparisons. Then, agendas were evaluated for importance according to each subcriteria, and rank ordered considering the weight calculated by multiplying the importance scores of the criteria and the subcriteria. RESULTS: We derived 25 agendas including 13 for institutional pharmaceutical care service, 8 for community pharmaceutical care service, and 4 for public-health related pharmaceutical care service. AHP model was constructed based on 4 criteria and 8 subcriteria by a hierarchical structure. From the AHP survey, the ‘Development of pharmaceutical care service for metabolic and chronic disease’ agenda accounted for the highest priority. CONCLUSION: We have developed the R&D agendas of the pharmaceutical care service which should be promoted. The results should be utilized by the government to nationally support the development of the standards and relevant regulations related to pharmaceutical care services in Korea.

Effect of SLCO1B1 T521C on Statin-induced Myotoxicity: A Systematic Review and Meta-analysis

BACKGROUND: This study was performed to clarify the effect of SLCO1B1 T521C on statin-induced myotoxicity. METHODS: The PubMed, Embase, Ovid, and Cochrane Library databases were searched for all published studies between database inception and April 2018. Using Review Manager 5, the pooled odds ratio (OR) and corresponding 95% confidence interval (CI) were determined to assess the effect of SLCO1B1 T521C on statin-induced myotoxicity by using different genetic models. RESULTS: Eleven observational studies and one randomized controlled trial were included in the meta-analysis. The pooled analysis showed that the incidence of statin-induced myotoxicity was significantly associated with the SLCO1B1 521C variant allele. Among patients using statins, the incidence of myotoxicity was higher in those carrying the 521TC or 521CC variant than in those carrying the 521TT variant in the dominant model (TC + CC vs TT, OR: 1.57; 95% CI: 1.20, 2.05; p = 0.001). The 521TC genotype was associated with a higher risk of myotoxicity than the 521TT genotype (OR: 1.42; 95% CI: 1.09, 1.86; p = 0.009). Furthermore, the incidence of myotoxicity was higher in 521CC carriers than in 521TC carriers (OR: 1.40; 95% CI: 1.06, 1.83; p = 0.02) and noticeably higher in 521CC carriers than in 521TT carriers (OR: 2.26; 95% CI: 1.23, 4.17; p = 0.009). CONCLUSION: The identification of individuals with the SLCO1B1 521C variant allele prior to the initiation of statin therapy might be useful to predict the risk of toxicity development, determine the individual dose, and prevent myotoxicity.

Attitudes to proposed assessment of pharmacy skills in Korean pharmacist licensure examination / 보건의료교육평가

PURPOSE: The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). METHODS: A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. RESULTS: A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%–48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. CONCLUSION: Pharmacy skills assessment was supported by the majority of respondents.

Middle East Respiratory Syndrome Outbreak and Responsiveness of the Pharmacy Programs on the Pharmacy Practice Education

BACKGROUND: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. METHODS: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. RESULTS: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. CONCLUSION: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.

Selection of Tasks for Assessment of Pharmacy Clinical Performance in Korean Pharmacist Licensure Examination: Results of an Expert Survey

OBJECTIVE: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. METHODS: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. RESULTS: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: ‘Patient (customer) reception’, ‘Drug preparation and distribution’, ‘Patient care’, ‘Administration’, ‘Patient counseling’, ‘Non-prescription medication counseling’, and ‘Provision of drug information’. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. CONCLUSION: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

An Investigation of Current Status of the Clinical Practice Guidelines in Korea

OBJECTIVE: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. METHOD: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. RESULTS: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. CONCLUSION: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

The Job Experience of Oncology Nurse Specialists

PURPOSE: The purpose of the study was to explore and describe the job experiences of oncology nurse specialists. METHODS: Nine oncology nurse specialists participated in the study. Data were collected through in-depth unstructured interviews with individual participants from February to June, 2014. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Corbin and Strauss's grounded theory method. RESULTS: From open coding, 98 concepts, 24 sub-categories, and 11 categories were identified. Analysis revealed that the core category of the job experiences of oncology nurse specialists was 'tightrope walking of professionalism without safeguards', consisting of four phases: Enthusiastic beginning, conflict, exertion, and internalization. To manage the 'tightrope walking of professionalism without safeguards', participants utilized various action/interactional strategies such as 'keeping the balance point' and 'taking a step forward.' As a result, participants experienced falling into a habitual routine and professional self-actualization. CONCLUSION: In-depth understanding of the job experiences of oncology nurse specialists will guide hospital administrators to promote effective interventions and policies to better support Korean oncology nurse specialists.

Predictive Factors for Long-term Clinical Outcomes in Patients with Variant Angina / 대한내과학회지

BACKGROUND/AIMS: The incidence of variant angina (VA) is relatively high in Korea compared with western countries, but its long-term clinical outcomes are not well defined. METHODS: Patients who underwent ergonovine provocation tests at the cardiac catheterization laboratory of Chonnam National University Hospital between 1996 and 2011 were enrolled in this study (n = 1162). Of them, 686 patients with positive ergonovine provocation tests were divided into two groups: patients with cardiac events (Group I: 153 patients, 52.4 +/- 11.0 years, M: F = 103: 50) and those without (Group II: 533 patients, 51.6 +/- 10.7 years, M: F = 350: 183). The mean follow-up duration was 40.2 +/- 38.0 months. Cardiac events were defined as cardiac death, recurrent ischemia, rehospitalization, myocardial infarction, and follow-up angiography. Clinical findings, laboratory and coronary angiographic characteristics were compared between the groups. RESULTS: A history of smoking was more common in Group I than in Group II (45.8% vs. 36.3%, p = 0.037). The levels of low-density lipoprotein cholesterol (119.4 +/- 35.3 vs. 111.1 +/- 32.2 mg/dL, p = 0.010) were higher in Group I than in Group II. According to Cox proportional hazard regression analysis, the major predictive factor for cardiac events during clinical follow-up was smoking (HR 1.80, 95% CI 1.036-3.126, p = 0.037). CONCLUSIONS: A history of smoking was the only independent risk factor for cardiac events during a long-term clinical follow-up in Korean patients with variant angina.

The Past, Present and Future Strategies of Korean Social Work in Hospice and Palliative Care / 한국호스피스완화의료학회지

The objective of this paper is to suggest future goals and strategies for social work in hospice and palliative care in Korea by understanding its historical background. Both literature review and participant observation were performed to examine historical data relating to social work in hospice and palliative care in Korea. Also reviewed were the current trends with a focus on the roles of social workers in the said arena, qualifications, education, research and medical insurance policy. First of all, the roles of social workers do not appear to be clearly defined in the field of hospice and palliative care, which seems to lead to the lack of recognition as professional workers. The qualification standard for social workers in hospice and palliative care remains inadequate. Second, there seems to be insufficient professional social worker training resources, in terms of both the number of educators and training programs. Third, social workers in Korea produce significantly less publications than those in other professions. There is also a dearth of qualified evidence-based research that is needed to prove benefits of intervention and ultimately for policy implications. Last, the current medical insurance policy needs to be revised to secure fees for social work services and dedicated full-time social workers in hospice and palliative care. Korea needs to approach social work in hospice and palliative care with specific goals to develop future strategies. Related infrastructure and an executive structure should be established via networking and partnership with academic societies, associations and schools.

Relationship of Followership to Organizational Commitment, Job Satisfaction, Turnover Intention, and Customer Orientation in Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the relationship among followership, organizational commitment, job satisfaction, turnover intention, and customer orientation in hospital nurses. METHODS: The participants in this study were 210 staff nurses in one university hospital. Data were analyzed using frequency, ANOVA, Pearson correlation analysis, and stepwise multiple regression. RESULTS: Followership had positive correlations with organizational commitment (r=.46, p<.001), job satisfaction (r=.41, p<.001), customer orientation (r=.47, p<.001). Followership had negative correlation with turnover intention (r=-.23, p<.001). The factor of followership influencing organizational commitment was active engagement, and this factor accounted for 23.3% of explanatory power. The factor of followership influencing job satisfaction was active engagement (F=45.00, p<.001), and this factor accounted for 17.8% of explanatory power. The factor of followership influencing turnover intention was active engagement (F=19.69, p<.001), and this factor accounted for 17.0% of explanatory power. The factors of followership influencing customer orientation were active engagement (F=51.38, p=.004) and independent, critical thinking (F=24.55, p=.011), and these factors accounted for 22.1% of explanatory power. CONCLUSION: Findings indicate a need to develop followership to promote organizational commitment, job satisfaction, and customer orientation and to decrease turnover intention in nurses.

Nurse's Job Satisfaction and Organizational Commitment according to Hospital Ethical Climate Types / 간호행정학회지

PURPOSE: This study was conducted to identify ethical climate factors in hospitals and analyze their influence on job satisfaction and organizational commitment. METHODS: A convenience sample of 196 nurses from one national university hospital in J city participated in this descriptive study survey. Instruments included the Ethical Climate Questionnaire, Job Satisfaction Scale, and Organizational Commitment Scale. Cronbach's alpha and factor analysis were done to test reliability and construct validity of the scales. Data were collected from March 15 to March 25, 2013 and analyzed using descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and multiple regression with SPSS/WIN 18.0. RESULTS: Seven ethical climate factors were identified; laws and professional codes, social responsibility, company rules and procedures, self-interest, personal morality, efficiency, and friendship. Factors influencing job satisfaction were friendship (beta=.25), social responsibility (beta=.20), laws and professional codes (beta=.20), and educational level (beta=.27), explaining 37.6% of variance in job satisfaction. Factors influencing organizational commitment included social responsibility (beta=.29), friendship (beta=.27), laws and professional codes (beta=.23), and age (beta=.19), with explanatory power of 44.6%. CONCLUSION: Results can be used as preliminary data for developing new strategies to establish positive ethical climates in hospital environments and thus enhance nurses' job satisfaction and organizational commitment.

Study on Fatigue, Stress and Burnout of Pregnant Nurses / 한국직업건강간호학회지

PURPOSE: This study is a correlative study to assess the relationships of fatigue, stress, and burnout among the pregnant nurses in hospital. METHODS: The subjects in this study were 103 nurses aged between 22 and 40 who were confirmed as pregnant by the OBGY (Obstetrics and Gynecology) hospital and working at medical facilities located in J-province of G city during the period of July 15 through September 15, 2010. RESULTS: The level of fatigue of pregnant nurses showed an average of 5.60 out of 10 points, and the level of stress showed an average of 25.91. In terms of burnout, the average was 2.72 out of 5 points. The results of the correlative study to assess relationships among fatigue, stress and burnout showed significant positive correlation between burnout and fatigue (r=.47, p<.001) and stress (r=.53, p<.001) and between stress and fatigue (r=.58, p<.001). Therefore, the results show that increased level of fatigue and stress leads to increased level of burnout. CONCLUSION: The results of the study showed that higher level of fatigue and stress led to higher level of burnout. Therefore, to minimize the burnout of pregnant nurses, many efforts are required in the hospital policy and for the strategies to reduce burnout.

Effects of a Yoga-focused Prenatal Program on Stress, Anxiety, Self Confidence and Labor Pain in Pregnant Women with In Vitro Fertilization Treatment

PURPOSE: The purpose of this study was to identify the effects of a Yoga-focused prenatal program on the stress, anxiety, self confidence and labor pain of pregnant women who had in vitro fertilization (IVF) treatment. METHODS: A quasi experimental study with a non-equivalent control group pretest-posttest design was used. The data collection period and meditation program were between January 9 and August 31, 2009. Forty-six women who were pregnant following IVF, and were between 12-20 weeks gestation, participated in the study (23 experimental group, 23 control group). Data were analyzed using Chi-square test, Mann-Whitney U Test, ANCOVA, and Cronbach's alpha coefficients with the SPSS 12.0 for Windows Program. RESULTS: Although the sample size was limited, women who participated in the program showed statistically significant improvements in stress, anxiety, labor pain, and labor confidence for women pregnant after IVF. CONCLUSION: The result indicate that this 12-week Yoga-focused educational program can be utilized for women pregnant following IVF to reduce their stress, anxiety, and labor pain, and to increase delivery confidence. It is suggested that the Yoga-focused educational program be offered to every pregnant woman.

Study on the Relationship between Gender-Role Stereotypes, Sexual Assault Awareness and Permissible limit in the College Students

PURPOSE: This study was done to identify the relationship between gender-role stereotypes, sexual assault awareness and permissible limits in the college students. METHODS: With a structured survey, a sample of 756 college students who agreed to participate in the study completed a self-administered questionnaire. RESULTS: The result showed that gender-role stereotypes differed significantly depending on gender and age, while awareness of sexual assault differed significantly depending on gender, age, and location of residence. The permissible limits in sexual assault differed significantly according to gender, relationship with parents, and location of residence. There were significant relationships among awareness of sexual assault, gender-role stereotypes, and permissible limits of sexual assault. CONCLUSION: The result will provide preliminary data and strategies to develop sexual assault prevention programs.

The Lived Experience of the Burnout of Nurses Working in Oncology Wards

PURPOSE: This study was done to understand the meanings and nature of experiences of the burnout of nurses working in oncology wards. METHODS: The hermeneutic phenomenology developed by van-Manen was used. The period for data collection was from November, 2006 to May, 2007. This study took place in 3 university hospitals in B & U cities. Nine nurses working in oncology wards participated. Data collection was done through individual in-depth interviews. RESULTS: The eight most common themes demonstrated by participants from this study were 'being fed up with endless demands', 'collapsing in front of deaths', 'gasping for breath due to overwhelming tasks', 'uncontrollable suffering of body', 'gradually loosing self-esteem', 'frustration from the work world', 'beleaguered relationships', and 'desire to escape'. CONCLUSION: The results of this study indicate that there is a need to develop a preventive burnout program for nurses working in oncology wards.

Polymorphism of SCN1A and SCN2A Gene in Pediatric Refractory Epilepsy Patients

PURPOSE: Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. While there have been many break throughs in development of antiepileptic medications, the cure for epilepsy still needs many answers, such as genetic aspects of the illness. Gene mutation may contribute to this situation. In this study, we have evaluated children with single nucleotide polymorphisms (SNP) of SCN1A c.3184 A-->G (rs2298771) and SCN2A c.56 G-->A (rs17183814) to analyze these genes were associated with refractory seizure.METHODS: Three hundreds and eleven children who visited the outpatient clinic in Chungnam National University Hospital, were retrospectively reviewed and, the data for their demographic profiles, clinical characteristics, and the results for SNP of SCN1A and SCN2A gene were collected. We divided them into three groups of control, response, and refractory groups.RESULTS: There was no statistical difference in demographic profiles of the patients. A variant of SCN2A c.56 G-->A polymorphism was associated with refractory seizure in pediatric patients with epilepsy (p=0.004; odds ratio 2.78, 95% confidence interval 1.39-5.56).CONCLUSIONS: SNP of SCN2A c.56 G-->A could be suggested as one of the causes of pediatric refractory epilepsy.

Polymorphism of SCN1A and SCN2A Gene in Pediatric Refractory Epilepsy Patients / 대한간질학회지

PURPOSE: Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizures. While there have been many break throughs in development of antiepileptic medications, the cure for epilepsy still needs many answers, such as genetic aspects of the illness. Gene mutation may contribute to this situation. In this study, we have evaluated children with single nucleotide polymorphisms (SNP) of SCN1A c.3184 A-->G (rs2298771) and SCN2A c.56 G-->A (rs17183814) to analyze these genes were associated with refractory seizure. METHODS: Three hundreds and eleven children who visited the outpatient clinic in Chungnam National University Hospital, were retrospectively reviewed and, the data for their demographic profiles, clinical characteristics, and the results for SNP of SCN1A and SCN2A gene were collected. We divided them into three groups of control, response, and refractory groups. RESULTS: There was no statistical difference in demographic profiles of the patients. A variant of SCN2A c.56 G-->A polymorphism was associated with refractory seizure in pediatric patients with epilepsy (p=0.004; odds ratio 2.78, 95% confidence interval 1.39-5.56). CONCLUSIONS: SNP of SCN2A c.56 G-->A could be suggested as one of the causes of pediatric refractory epilepsy.

The Role of Endothelin Receptor A during Myelination of Developing Oligodendrocytes

Endothelin (ET)-1 and its receptors (ETA and ETB receptor) are present in the central nervous system. ET exerts biological effects on gliogenesis and glial cell functions. In order to define a possible mechanism of ETA receptor signaling, the distribution of the ETA receptor in developing oligodendrocytes and the effects of ET-1 on the myelination of oligodendrocytes were examined. ETA receptor immunoreactivity was confined to the perivascular elements of the blood vessels during early postnatal development. However later in development, ETA receptor immunoreactivity was no longer observed in the vessels but became localized to the myelinating oligodendrocytes of the primitive corpus callosum of the white matter, apart from the vessels. ET-1 induced myelin basic protein (MBP) in primary oligodendrocyte precursor cell culture though the ETA receptor and was blocked by an ETA receptor antagonist. In addition, ET-1 evoked the release of Ca2+ which is a central regulator of oligodendrocyte differentiation. Our results provide a link between ET-1 and its ETA receptor and myelination during oligodendrocyte differentiation.