Clinical impact of admission hyperglycemia on in-hospital mortality in acute myocardial infarction patients

Kim, Eun Jung,Jeong, Myung Ho,Kim, Ju Han,Ahn, Tae Hoon,Seung, Ki Bae,Oh, Dong Joo,Kim, Hyo-Soo,Gwon, Hyeon Cheol,Seong, In Whan,Hwang, Kyung Kuk,Chae, Shung Chull,Kim, Kwon-Bae,Kim, Young Jo,Cha, Kwa Elsevier 2017 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.236 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acute hyperglycemia on admission is common in acute myocardial infarction (AMI) patients regardless of diabetic status, and is known as one of prognostic factors. However, the effect of hyperglycemia on non-diabetic patients is still on debate.</P> <P><B>Methods</B></P> <P>A total of 12,625 AMI patients (64.0±12.6years, 26.1% female) who were enrolled in Korea Acute Myocardial Infarction Registry-National Institute of Health between November 2011 and December 2015, were classified into 4367 diabetes (65.4±11.6years, 30.4% female) and 8228 non-diabetes (63.3±13years, 23.9% female). Patients were analyzed for in-hospital clinical outcome according to admission hyperglycemic status.</P> <P><B>Results</B></P> <P>In diabetic patients, independent predictors of in-hospital mortality were old age, high HbA<SUB>1</SUB>C, pre-Thrombolysis In Myocardial Infarction (TIMI) flow 0, left ventricle ejection fraction<40%, cardiogenic shock and ventricular tachycardia. In non-diabetic patients, independent predictors of in-hospital mortality were old age, high admission glucose (≥200mg/dL), pre TIMI flow 0, failed percutaneous coronary intervention, low left ventricle ejection fraction<40%, cardiogenic shock, stent thrombosis and decreased Hb≥5g/dL. In hospital mortality was significantly higher in diabetic patients compared to non-diabetic patients (5.0% vs. 3.4%, <I>p</I> <0.001). However, non-diabetic patients with hyperglycemia have significantly higher mortality compared to diabetic patients (17.4% vs. 7.2%, <I>p</I> <0.001). Comorbidity including cardiogenic shock (<I>p</I> <0.001), cerebral hemorrhage (<I>p</I> =0.012), decreased Hb≥5g/dL (<I>p</I> =0.013), atrioventricular block (<I>p</I> <0.001) and ventricular tachycardia (<I>p</I> =0.007) was higher in non-diabetic with hyperglycemia than in diabetic patients.</P> <P><B>Conclusions</B></P> <P>These findings underscore clinical significance of admission hyperglycemia on in-hospital mortality in non-diabetic AMI patients.</P>

Effects of Phenytoin and Diazepam on the Seizure Activity in the Cortical Dysplasia Animal Models

Kim, Si-Hyung,Choi, In-Sun,Cho, Jin-Hwa,Park, Eun-Ju,Jang, Il-Sung,Choi, Byung-Ju,Kim, Hyun-Jung,Kim, Young-Jin,Nam, Soon-Hyeun The Korean Academy of Oral Biology 2006 International Journal of Oral Biology Vol.31 No.2

Dysplasia-associated seizure disorders are markedly resistant to pharmacological intervention. Relatively little research has been conducted studying the effects of antiepileptic drugs(AEDs) on seizure activity in a rat model of dysplasia. We have used rats exposed to methylazoxymethanol acetate(MAM) in utero, an animal model featuring nodular heterotopia, to investigate the effects of AEDs in the dysplastic brain. Pilocarpine was used to induce acute seizure in MAM-exposed and age-matched vehicle-injucted control animals. Field potential recordings were used to monitor amplitude and numbers population spikes, and paired pulse inhibition in response to stimulation of commissural pathway. Two commonly used AEDs were tested: diazepam 5, 2.5mg/kg;phenytoin 40, 60mg/kg. Diazepam(DZP) and phenytoin(PHT) reduced the amplitude of population spike in control and MAM-exposed rats. However, the amplitude of population spike was nearly eliminated in control rats as compared to the MAM-exposed rats. Pharmaco-resistance was tested by measuring seizure latencies in awake rats after pilocarpine administration(320mg/kg, i.p.) with and without pretreatment with AEDs. Pre-treatment with PHT 60 mg prolonged seizure latency in control rats, but not in MAM-exposed animals. The main findings of this study are that acute seizures initiated in MAM-exposed rats are relatively resistant to standard AEDs assessed in vivo. These data suggest that animal model with cortical dysplasia can be used to screen the effects of potential AEDs.

2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

내원시 저혈당이 당뇨병을 동반한 심근경색증 환자의 예후에 미치는 영향

김은정 ( Eun Jung Kim ),정명호 ( Myung Ho Jeong ),정인석 ( In Seok Jeong ),오상기 ( Sang Gi Oh ),김상형 ( Sang Hyung Kim ),안영근 ( Young Keun Ahn ),김주한 ( Ju Han Kim ),김영조 ( Young Jo Kim ),채성철 ( Shung Chull Chae ),홍택종 대한내과학회 2014 대한내과학회지 Vol.87 No.5

목적: 당뇨병 환자에게 철저한 혈당 조절은 논란의 여지가 있으며, 이에 당뇨병을 동반한 급성 심근경색증 환자의 내원 시 저혈당과 병원 내 주요 임상 사건 및 사망률 그리고 추적관찰 1년간 사망률과의 관계를 알아보고자 하였다. 방법: 2005년 11월부터 2012년 3월까지 KAMIR에 등록된 당뇨병이 동반된 급성 심근경색증 환자 5,249명을 혈당 수치에 따라서 저혈당을 보인 환자(≤ 70 mg/dL)를 I군(93명, 72.6± 11.0세, 여성 46.2%), 정상혈당을 보인 환자(> 70 and < 140)를 II군(1,262명, 71.3 ± 10.7, 여성 34.3%), 고혈당을 보인 환자(≥ 140)를 III군(3,894명, 70.3 ± 11.1, 여성 36.0%)으로 분류하여, 병원 내 주요 임상사건 및 1년 후 사망률과의 관계를 비교하였다. 결과: 각 군의 평균 연령은 I군(72.6 ± 11.0세), II군(71.3 ±10.7세), III군(70.3 ± 11.1세)으로 I군에서 연령이 높았다(p =0.006). I군에서 내원 시 비전형적인 증상 양상(p = 0.002), Killip class III-IV (p = 0.003), 심초음파을 이용한 좌심실 구혈률 40% 미만의 환자(p = 0.002), NSTEMI가 많았다(p = 0.001). 전체 대상 환자 5,249명 중 344명(6.6%)이 입원 중 사망하였으며, 이 중에서 I군 12명(12.9%), II군 66명(5.2%), III군 266명(6.8%)으로 I군에서 사망률이 유의하게 높았다(p = 0.006).다변량 회귀분석에서 나이(p = 0.001), Killip class III-IV (p =0.001), 뇌혈관 질환(p = 0.002), 만성 신부전증(p = 0.001), 급성 신부전증(p = 0.001), 심인성 쇼크(p = 0.001), 심실성 빈맥증(p = 0.005), 좌심실 구혈률 40% 미만(p = 0.001), 내원시 혈당 70 mg/dL 미만(p = 0.005)은 추적관찰 한 달간 사망률에 독립적인 예측인자이었다. 정상 혈당군에 비하여 저혈당 군에서 사망률이 유의하게 증가하였고(OR 3.571, 95% CI1.465-8.705, p = 0.005). 고혈당군에 비해 저혈당군에서 사망률이 유의하게 증가하였다(OR 4.088, 95% CI 1.757-9.511, p= 0.001). 그러나 추적관찰 1년간에서 내원시 혈당은 사망률의 유의한 예측인자가 아니었다(p = 0.428). 결론: 당뇨병을 동반한 심근경색증 환자의 내원 시 저혈당은 입원중과 추적관찰 한 달간의 사망률을 예측할 수 있는 예후인자였다. Methods: We analyzed 5,249 diabetic patients who enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to March 2013. The patients were divided into three groups according to their blood glucose level at admission; Group I:hypoglycemia (≤ 70 mg/dL), Group II: normoglycemia (70-140 mg/dL) and Group III: hyperglycemia (≥ 140 mg/dL). We assessed in-hospital mortality and the major adverse cardiac events based on blood glucose levels at admission. Results: The mean age was older in group I at 72.6 ± 11.0 years compared to 71.3 ± 10.7 in group II and 70.3 ± 11.1 in group III (p < 0.006). A total of 344 patients died during hospitalization. In-hospital mortality was higher in group I at 12.9%, compared to 5.2% in group II and 6.8% in group III (p < 0.006). Multivariable logistic regression analysis determined that the independent predictors of 1-month mortality were age, Killip class III-IV, cerebrovascular disease, chronic renal failure, acute renal failure, cardiogenic shock, ventricular tachycardia, ejection fraction < 40% and hypoglycemia in admission. The mortality rate at 1 month was significantly higher in group I compared to group II (odds ratio [OR] 3.571; 95% confidence interval [CI] 1.465-8.705, p = 0.005) compared to group II and group III (OR 4.088; 95% CI 1.757-9.511, p = 0.001). Conclusions: Hypoglycemia on admission was an important predictor of in-hospital and one-month mortality in AMI patients with diabetes mellitus. (Korean J Med 2014;87:565-573)

Impact of total occlusion of an infarct-related artery on long-term mortality in acute non-ST-elevation myocardial infarction patients who underwent early percutaneous coronary intervention.

Kim, Min Chul,Ahn, Youngkeun,Rhew, Shi Hyun,Jeong, Myung Ho,Kim, Ju Han,Hong, Young Joon,Chae, Shung Chull,Kim, Young Jo,Hur, Seung Ho,Seong, In Whan,Chae, Jei Keon International Heart Journal Association 2012 International heart journal Vol.53 No.3

<P>Some patients with non-ST-elevation myocardial infarction (NSTEMI) have a total occlusive infarct-related artery. However, the long-term prognosis of these patients is uncertain, particularly for those who underwent an early invasive strategy. The aim of this study was to determine the clinical impact of total occlusion (TO) of an infarct-related artery (IRA) in these patients. A total of 2,094 patients with NSTEMI who underwent an early invasive strategy with percutaneous coronary intervention (PCI) in the Korea Acute MI Registry (KAMIR) were analyzed (TO group; 665 patients, and non-TO group; 1,429 patients).In-hospital and one-year clinical outcomes were compared between the two groups. The left circumflex (42.9%) and right coronary artery (31.9%) were the major IRA in the TO group, while the left anterior descending artery was more common as an IRA in the non-TO group (44.1%). In-hospital complications including death and cardiogenic shock occurred frequently in the TO group. Also, the rates of one-month and 12-month adverse cardiac outcomes were higher in the TO group. In the Cox-proportional hazard model, TO in IRA predicted 12-month all-cause death. In conclusion, NSTEMI patients with TO in IRA showed worse short- and long-term clinical outcomes compared with those of non-TO patients.</P>

Condylar positioning changes following unilateral sagittal split ramus osteotomy in patients with mandibular prognathism

Kim, Myung-In,Kim, Jun-Hwa,Jung, Seunggon,Park, Hong-Ju,Oh, Hee-Kyun,Ryu, Sun-Youl,Kook, Min-Suk Korean Association of Maxillofacial Plastic and Re 2015 Maxillofacial Plastic Reconstructive Surgery Vol.37 No.-

Background: This study was performed to evaluate three-dimensional positional change of the condyle using three-dimensional computed tomography (3D-CT) following unilateral sagittal split ramus osteotomy (USSRO) in patients with mandibular prognathism. Methods: This study examined two patients exhibiting skeletal class III malocclusion with facial asymmetry who underwent USSRO for a mandibular setback. 3D-CT was performed before surgery, immediately after surgery, and 6 months postoperatively. After creating 3D-CT images by using the In-vivo $5^{TM}$ program, the axial plane, coronal plane, and sagittal plane were configured. Three-dimensional positional changes from each plane to the condyle, axial condylar head axis angle (AHA), axial condylar head position (AHP), frontal condylar head axis angle (FHA), frontal condylar head position (FHP), sagittal condylar head axis angle (SHA), and sagittal condylar head position (SHP) of the two patients were measured before surgery, immediately after surgery, and 6 months postoperatively. Results: In the first patient, medial rotation of the operated condyle in AHA and anterior rotation in SHA were observed. There were no significant changes after surgery in AHP, FHP, and SHP after surgery. In the second patient, medial rotation of the operated condyle in AHA and lateral rotation of the operated condyle in FHA were observed. There were no significant changes in AHP, FHP, and SHP postoperatively. This indicates that in USSRO, postoperative movement of the condylar head is insignificant; however, medial rotation of the condylar head is possible. Although three-dimensional changes were observed, these were not clinically significant. Conclusions: The results of this study suggest that although three-dimensional changes in condylar head position are observed in patients post SSRO, there are no significant changes that would clinically affect the patient.

의료방사선관리의 국제화 연구 : 핵의학분야의 의료방사선관리

김인규,오헌진,김혁주,오현주,박기정,이광용,이병영,정승환,강영규,이현구,김귀야,한상용,김연교,양현규,이명철 식품의약품안전청 2001 식품의약품안전청 연보 Vol.5 No.-

의료방사선은 인간의 질병진료와 예밤에 활용되어 각종 질병으로부터의 적절한 진단 및 의학발전에 중대한 역할을 담당하고 띤다. 또한 인공방사선원중 가장 큰 비중을 차지하고 있으며, 방사선원을 이웅한 이득과 손실을 생각쌀 때 피폭선량의 최소화 및 곡률적영향의 최소화를 위해 이득을 최대화하는 노력을 하고 있다. 진단뿐만 아니라 치료에도 사응하고 있는 인공방사선원의 적절한 관리를 위한 조사 및 연구는 국내에서는 아픽까진 실시되지 않았으며, 국외에서는 이미 활발한 조사 덴 연구가 이루어 지 고 있다. 일반적으로 의료기관의 핵의학분야에서 환자의 진단 및 치료에 사용되는 방사성의약품으로는 Tc-99in, Ga-67, 1-131, 71-201 등이 있으며 이를 이용한 방사능측정웅장비 및 치료뭉장비에는 Gamma Camera, 감마선재측기, 베타선계측기, Dose CaTibrator, PET(양전자방출전산화단층촬영장치)등이 있다. 이어 식푿의약품안전청f"서는 핵의학분야의 방사선보건학적 연구를 위해 핵의학분야의 진료와 관련된 인력, 시설, 장비, 방사성의약품의 사응, 핵의학적 진료형태 및 핵의학적 진료장치에 대한 성능관리등에 대해 조사·연구하였다. A nationwide survey was conducted in the Korea in 2001 to determine the facilities available and the level of activity at centres where radionuclide and therapy was practised in 2000. A response rate of 75% indicated that 120 centres were providing radionuclide therapy and diagnosis. About the good treatment of radionuclide using in medical, researched so many country, but not yet in. Generally nuclear medical part use Tc-99m, Ga-67, I-131, Tl-201 in diagnosis and therapy, radiation detector and equipment for therapy use Gamma Camera, beta-counter, Dose Calibrator PET(Positron Emission Tomography). 81% rate of centre has Gamma Camera and 97% rate of use Tc-99m, I-131 radionuclide. In-vitro did more than in-vivo test absolutely. So in KFDA researched in unclear medical part in Man-Power, facilities, equipment use of nuclear medicine, part of diagnosis and diagnosis equipment.

원발성 유방암에서 Sodium Iodide Symporter의 발현과 ^(99m)Tc-MIBI 유방스캔의 관계

석주원,김성장,곽희숙,이창훈,김인주,김용기,배영태,김동수 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.6

목적: hNIS는 갑상선 조직 외에 다른 조직들에서도 발현된다고 알려져 있다. 유방암 세포는 그런 조직들 중에 하나이며, 그에 의한 유방암의 방사성옥소치료의 가능성이 제시되고 있다. 본 연구에서는 유방암 조직에서 hNIS의 발현정도를 알아보고, ^99mTc-MIBI 유방스캔과 hNIS의 발현 정도와의 관계를 조사하여 보았다. 대상 및 방법: 본 연구에서는 유방암으로 수술을 시행했던 56명의 환자를 대상으로 하였다. hNIS의 발현은 면역조직화학염색에 의해서 평가되었으며, 그 결과를 ^99mTc-MIBI 유방스캔의 판정 결과와 비교하였다. 결과: 전체 56명의 환자에서 hNIS의 발현율은 41.1%였다. 병리학적 진단에 의해 침윤성관상피암종이었던 49명에서의 발현율은 42.9%, 관상피내암종이었던 7명에서의 발현율은 28.6%였다. ^99mTc-MIBI 유방스캔에서 국소섭취 소견이 관찰되었던 41명에서의 hNIS의 발현율은 31.7%였다. 비정상적인 섭취 소견이 관찰되지 않았던 15명의 환자에서의 hNIS의 발현율이 의미있게 높게 관찰되었다(66.7%, p>0.05). 결론: 유방암 환자에서의 hNIS의 발현율은 그다지 높지 않았다. ^99mTc-MIBI 유방스캔에서 섭취증가 소견이 없을 때 hNIS의 발현율이 더 높았다. Purpose: Human Na^+/I- symporter (hNIS) is known to be expressed in many tissues other than thyroid gland. The breast cancer cells are one of them and the possibility of radioiodine therapy in treatment of the breast cancer may be suggested. We investigated the expression rate of hNIS and the relationship between the expression of hNIS and the finding of 99mTc-MIBI scintimammography in the breast cancer. Materials and Methods: Surgically proved 56 patients with breast cancer were the subjects of this study. The expression of hNIS were evaluated by immunohistochemistry and the results were compared to the findings of 99mTc-MIBI scintimammography. Results: Overall expression rate of hNIS was 41.1% in 56 patients. According to the pathologic diagnosis, it was 42.9% in 49 patients with invasive ductal carcinoma and 28.6% in the 7 patients with ductal carcinoma in situ. The expression rate of hNIS in the 41 cases with a focal increased uptake at he breast lesion on 99mTc-MIBI scintimammogram was 31.7%. That in the 15 cases without any abnormal uptake on the scan was significantly higher(66.7%, p<0.05). Conclusion: The expression rate of hNIS in the patients with breast cancer was not so high. The rate was higher in the patients with no increased uptake at the breast lesion on 99mTc-MIBI scintimammography. (Korean J Nucl Med 2002;36;325-32)

양·한방 협진 대학병원 간호사의 업무 스트레스와 직무만족도 비교연구

강승주,김인숙 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

Objective: This study is descriptive comparison investigation study to compare grasping western and Oriental Medicine nurse's job stress and job satisfaction degree which work in university hospital. Method: Study population was 177 nurses who worked in the 2 Internal and Oriental Medicine university hospital in Gwang-ju and 1 Western and Oriental Medicine university hospital situated in Chollabukdo and the data was collected from September 1 to September 20, 2004. SPSS program was used for statistical analysis and the data were ana- lysed by the use of freuency, Percentages, t-test, ANOVA, Pearson's Correlation coefficients, and Scheffe's test. Resutt: The study findings were as follows: 1. Difference between subject person's two group of job stress degree, Internal Medicine nurses business stress whole grades is 3.24 points, and Oriental Medicine nurses business stress whole grades was 2.71 points. 2. There was difference that business stress degree by subject person's general special quality keeps in mind in positional 3.74, p=.000), health (t=11.93, P=.000), work schedule period(F=10.60, P=,000) in Internal Medicine nurses, and in age(F=4.43, P=.006), education opportunity (F=3.91, P=.024), satisfaction factor(F=3.76, p=.007) in Oriental Medicine nurses. Job satisfaction by general special quality was similar difference in education opportunity(F=3.43, p=.037), hea1th(F=6.34, P=0.35), work schedule period(F=10.60, P=.000) in Internal Medicine nurses and there was similar difference in education opportunity(F=5.72, P=.005) in Oriental Medicine nurses(P<-001). 3. According to result that analyze business stress and interrelation between job satisfaction, job satisfaction was low as business stress is high displaying station interrelation in business stress and job satisfaction(r=-.453, P=.000). As business stress is high displaying station interrelation in Internal Medicine nurses, Oriental Medicine nurses, job satisfaction was low (r=-.430, P=.000). 4. Difference between subject person's two group of job satisfaction Internal Medicine nurses 2.51 points be and Oriental Medicine nurse's job satisfaction whole grades difference that Oriental Medicine nurse's job satisfaction was some high than Internal nurses but keeps in mind between two group because it is 2.55 points be. Conclusion: systematic reform measure with education, work environment development that can manage stress because control of business stress becomes important factor to increase job satisfaction that need known support consider.

[Ca(2+)]-dependent generation of intracellular reactive oxygen species mediates maitotoxin-induced cellular responses in human umbilical vein endothelial cells.

Yi, Sun-Ju,Kim, Kyung Hwan,Choi, Hyun Jung,Yoo, Je Ok,Jung, Hyo-Il,Han, Jeong-A,Kim, Young-Myeong,Suh, In Bum,Ha, Kwon-Soo Korean Society of Molecular Biology 2006 Molecules and cells Vol.21 No.1

<P>Maitotoxin (MTX) is known as one of the most potent marine toxins involved in Ciguatera poisoning, but intracellular signaling pathways caused by MTX was not fully understood. Thus, we have investigated whether intracellular reactive oxygen species (ROS) are involved in MTX-induced cellular responses in human umbilical vein endothelial cells. MTX induced a dose-dependent increase of intracellular [Ca(2+)]. MTX stimulated the production of intracellular ROS in a dose- and time-dependent manner, which was suppressed by BAPTA-AM, an intracellular Ca(2+) che-lator. Ionomycin also elevated the ROS production in a dose-dependent manner. MTX elevated transamidation activity in a time-dependent manner and the activation was largely inhibited by transfection of tissue transglutaminase siRNA. The activation of tissue transglutaminase and ERK1/2 by MTX was sup-pressed by BAPTA-AM or ROS scavengers. In addition, MTX-induced cell death was significantly de-layed by BAPTA-AM or a ROS scavenger. These results suggest that [Ca(2+)]-dependent generation of in-tracellular ROS, at least in part, play an important role in MTX-stimulated cellular responses, such as activation of tTGase, ERK phosphorylation, and in-duction of cell death, in human umbilical vein endothelial cells.</P>