Although extracellular $Ca^{2+}$ entry through the voltage-dependent $Ca^{2+}$ channels plays an important role in the spontaneous phasic contractions of the pregnant rat myometrium, the role of the T-type $Ca^{2+}$ channels has yet to be fully identified. The aim of this study was to investigate the role of the T-type $Ca^{2+}$ channel in the spontaneous phasic contractions of the rat myometrium. Spontaneous phasic contractions and $[Ca^{2+}]_i$ were measured simultaneously in the longitudinal strips of female Sprague-Dawley rats late in their pregnancy (on day 18 ${\sim}$ 20 of gestation: term=22 days). The expression of T-type $Ca^{2+}$ channel mRNAs or protein levels was measured. Cumulative addition of low concentrations (< 1 ${\mu}M$) of nifedipine, a L-type $Ca^{2+}$ channel blocker, produced a decrease in the amplitude of the spontaneous $Ca^{2+}$ transients and contractions with no significant change in frequency. The mRNAs and proteins encoding two subunits (${\alpha}$ 1G, ${\alpha}$ 1H) of the T-type $Ca^{2+}$ channels were expressed in longitudinal muscle layer of rat myometrium. Cumulative addition of mibefradil, NNC 55-0396 or nickel induced a concentration-dependent inhibition of the amplitude and frequency of the spontaneous $Ca^{2+}$ transients and contractions. Mibefradil, NNC 55-0396 or nickel also attenuated the slope of rising phase of spontaneous $Ca^{2+}$ transients consistent with the reduction of the frequency. It is concluded that T-type $Ca^{2+}$ channels are expressed in the pregnant rat myometrium and may play a key role for the regulation of the frequency of spontaneous phasic contractions.
Lee, Ah Reum;Jang, Seol;Lee, A Yeong;Choi, Goya;Kim, Hyo Seon;Kim, Ho Kyoung
Korean Journal of Medicinal Crop Science
/
v.22
no.2
/
pp.147-153
/
2014
The Ponciri fructus immaturus (Poncirus trifoliata Rafinesque) has been used in oriental medicine for uterine contraction, stomachache, abdominal distension and cardiovascular diseases. Two main compounds, poncirin and naringin were successfully analyzed by high performance liquid chromatography (HPLC) and carried out method validation according to ICH guideline. A successful resolution and retention times were obtained with a $C_{18}$ reversed phase column, at an $1m{\ell}min^{-1}$ flow rate, with a gradient elution of a mixture of methanol, water and acetonitrile. Poncirin and naringin showed good linearity ($R^2$ > 0.999) in relatively wide concentration ranged. The recovery of each compound was 95.81 ~ 101.48% with R.S.D. values less than 1.0%. The application of ultrasound-assisted extraction was shown to be more efficient in extracting poncirin and naringin from Ponciri fructus immaturus. The predicted optimal poncirin and naringin yield were poncirin 2.15%, naringin 1.65% under an extraction temperature of $40^{\circ}C$, an extraction time of 10 min in a solvent of 70% methanol.
Purpose: To analyze the job of nursing unit managers working at women's hospital, using DACUM (developing a curriculum), DACUM is a method for analyzing job-focused competency. Methods: This study involved a descriptive survey. A DACUM workshop was held to define women's hospital nursing unit managers' role and identify their duties and tasks. For the workshop, a committee was formed consisting of 5 women's hospital nursing unit managers. Finally, after validation, the developed contents were made into a survey asking about nursing unit manager's duties and tasks. Results: Sixteen duties and 83 tasks were identified on the DACUM chart. The importance, difficulty, and frequency of the tasks were ranked in terms of A, B, and C, with A being the highest degree. Eight tasks received A's all in importance, difficulty, and frequency of performance. The 8 tasks were: 'taking over', 'taking care of seriously ill patients on handover', 'ward rounding', 'analyzing and resolving demands identified during handover and patient tour', 'reporting patient status during rounding', 'promoting breast-feeding', 'uterine contraction, and training for breast-feeding'. The duty with the biggest determinant coefficient (DC) was 'patients complaint management' (DC=7.09). Based on tasks, the one with the biggest DC was 'solving patient and patient guardian's complaints' (DC=7.53), followed by 'making infection control guidelines' (DC=7.5). Conclusion: When expanding the nursing staff of the hospital, women's hospitals nursing unit managers also need to use administrative functions as intermediaries to focus on the operation management of the entire hospital rather than direct nursing to suit their role.
Lee, Dae Jun;Kim, Chang In;Jee, Young Goo;Lee, Kye Young;Kim, Keun Yeol;Choi, Young Hi;Seo, Pil Weon
Tuberculosis and Respiratory Diseases
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v.44
no.1
/
pp.183-190
/
1997
Tocolytics are agents widely used in the treatment of premature labor to inhibit uterine contractions. Ritodrine is most commonly used tocolytic agent and acts by increasing intracellular cyclic adenosine monophosphate, which decreases the activity of myosin light-chain kinase, the rate-limiting enzyme in the signal network leading to contraction. Physiologic effects associated with the use of ritodrine are due to their effect on bera-l as well as beta-2 receptors. Some of maternal complications of therapy are rachycardia, hyperglycemia, hypokalemia, lactic acidosis, myocardial ischemia, and pulmonary edema. Tocolytics induced pulmonary edema is a serious complication that can lead to marternal death, although infrequent, The incidence varies from 0.5% to 5% of those receiving these agents. Predisposing factors include the concommitant use of corticosteroid, twin gestation, fluid overload (particularly with saline), and anemia. Several mechanisms have been postulated, but the pathogenesis is uncertain. It is suggested that both types of mechanism, hydrostatic and permeability induced, might be involved. The association of tocolytic therapy with pulmonary edema appears to be unique to the pregnant state, because this complication has never been reported in asthmatic patients exposed to high dosages. We report a case of tocolytic induced pulmonary edema developed in 24 hours after delivery.
Purpose: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. Methods: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. Results: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. Conclusion: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.
Kim, Hyo-Jung;Kim, Eun-Seop;Jin, Dae-Hwan;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
The Journal of Korean Obstetrics and Gynecology
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v.32
no.1
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pp.85-93
/
2019
Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of mid-trimester oligohydramnios. Methods: It is a case report of a 31 year-old woman hospitalized for oligohydramnios at $24^{+4/7}$weeks of gestation. This patient diagnosed with special oligohydramnios had no abnormal findings such as fetal urinary abnormalities or other anomalies. Also, symptom of PPROM (preterm premature rupture of membrane) was not confirmed. The decoction, Gami-danggui-san (DG) was prescribed for the purpose of reducing unnecessary contraction of uterine muscle during pregnancy and promoting blood circulation and metabolism, thereby improving placental function and contributing to the increase of the fluid. DG decoction was administered twice a day until 19th of June, which was 10 days in total. During the treatment, level of amniotic fluid had been monitored by measuring AFI (amnioti fluid index). Results: After these conventional therapies, the amount of amniotic fluid increased steadily, and eventually reached the optimal level. AFI was found to be 3.2 on the $24^{+4/7}$ weeks, 8 on the $26^{+1/7}$ weeks, 11.5 on the $27^{+0/7}$ weeks of gestation. In the same periods, EFW (expected fetal weight) was also found to be increasing gradually: 545 g, 630, and 760 g. Conclusions: Our report implies the potential of herbal medicine as a effective therapy for oligohydramnios tratment. Further studies are needed to assess the efficacy of TKM herbal medicine and reveal the mechanisms of the decoction.
Oxytocin is a neurohypophyseal hormone which has multiple functions in mammals. Mainly, oxytocin regulates milk ejection and has an effect on uterine contraction and is related to maternal behavior. Maternal behavior is believed to be suppressed by stress and facilitated by oxytocin. In the cesarean section, oxytocin may be administrated into uterus to promote uterine involution. The present study aimed to test the effect of oxytocin into uterus on maternal behavior of rats with cesarean section. It was measured the effects on maternal behavior of oxytocin infused into uterus in rats with cesarean section as a stressor. In the first experiment, pup survival rate of between a control group and a group with laparotomy as a stress in natural parturition rats was compared. In the second experiment, survival rate for 2 weeks and maternal pup searching behavior (MPSV) were observed in one cesarean sectioned group without oxytocin and the other cesarean sectioned group with oxytocin. Infanticide was observed in stressed group in the first experiment while a normal maternal behavior was observed in a control one. In the second experiment, MPSV was only observed in a cesarean sectioned group with oxytocin and infanticide was observed in two groups except one rat which is thought to be affected by oxytocin as operated relatively late. This is the first study to show that the administration of oxytocin into uterus in the cesarean section is not involved in the regulation of maternal behavior in rats. In conclusion, this study proves the needs of oxytocin into brain in cesarean section related rats model and further study of maternal behavior list, like MPSV.
$PGE_2$ and $PGF_{2{\alpha}}$ are known to act similarly in a number of animal tissues. They both facilitate regression of corpus luteum(Poyser, 1972; Fuch et al, 1974; Coudert et at, 1974) and stimulate contraction of uterine muscle (Laudanski et al, 1977; Porter et al, 1979; Hollingsworth et al, 1980). It is, however, not known whether these two prostaglandins exert similar actions in osmotic fragility of erythrocytes (Rasmussen et al, 1975) and $PGF_{2{\alpha}}$ alters conformation of membrane proteins (Meyers aud Swislocki, 1974). The former effect may not be mediated through changes in c- AMP concentration in the cell, since the adenylate cyclase activity in human erythrocyte is extremely low (Rodan et al, 1976; Sutherland et al, 1962) and the latter effect implies that physical state (or fluidity) of the membrane is altered by $PGF_{2{\alpha}}$. The present study was undertaken to elucidate mechanisms of action of $PGE_2$ and $PGF_{2{\alpha}}$ on the human erythocyte membrane by examining their effects on osmotic fragility and $Ca^{++}$ binding to the membrane fragments. The results are summarized as follows: 1) $PGE_2$ and $PGF_{2{\alpha}}$ increased osmotic fragility at concentrations above $10^{11}\;M$, the effect being similar for both hormones. The concentration of NaCl for 100% hemolysis was $1/16{\sim}1/17\;M$ in the presence of $10^{11}\;M\;PGE_2$ or $PGF_{2{\alpha}}$ and 1/18 M in the absence of the hormone (control). 2) When erythrocytes were suspended in 1/15 M NaCl solution, $44.2{\pm}4.3%$ of cells were hemolyzed. Addition of $10^{12}\;M\;PGE_2$ or $PGF_{2{\alpha}}$ did not increase hemolysis. When the concentration of the hormones was increased to $10^{11}\;M$, however the degree of hemolysis increased markealy to about 80%. No further increase in hemolysis was observed at concentration of the hormones above $10^{11}\;M$. 3) The additional hemolysis due to $10^{11}\;M\;PGE_2$ and $PGF_{2{\alpha}}$ appeared to he identical regardless of absence or presence of $Ca^{++}\;(0.5{\sim}10\;mM)$ in the suspending medium. 4) In the absence of prostaglandin, the binding of $Ca^{++}$ to the erythrocyte membrane increased curvilinearly as the $Ca^{++}$ concentration increased up to 5 mM above which it leveled off. A similar dependence of $Ca^{++}$ binding on the $Ca^{++}$ concentration was observed in the presence of $10^{11}\;M\;PGE_2$ or $PGF_{2{\alpha}}$, however, the amount of $Ca^{++}$ bound at a given $Ca^{++}$ concentration was significantly higher than in the absence of the hormones. 5) As in the hemolysis, $PGE_2$ and $PGF_{2{\alpha}}$ did not affect the $Ca^{++}$ binding at a concentration of $10^{12}\;M$, but increased it by about 100% at concentration above $10^{11}\;M$. These result indicate that both tile osmotic fragility of erythrocyte and the $Ca^{++}$ binding to the erythrocyte membrane are similarly enhanced by $PGE_2$ and $PGF_{2{\alpha}}$, but these two effects are not causally related. It is, therefore, concluded that the prostaglandin-induced hemolysis is not directly associated with alterations of the $Ca^{++}$ content in the membrane.
According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.
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