Management of Discolored Anterior Teeth with Pulp Canal Obliteration

The purpose of this article is to present the effect and follow-up results of combined single-tooth vital bleaching when discoloration is due to pulp canal obliteration. In these cases, discoloration was managed successfully via home bleaching with a customized single-tooth tray and in-office bleaching without root canal treatment.

Factors Influencing on Problem Solving Ability of Nursing Students Experiencing Simulation Practice

It has become important for nurses to implement self-leadership and exercise critical thinking in problem-solving to address the health issues of patients. This has led to a need for nursing education programs in which nursing students learn to embrace self-leadership and self-evaluation approaches to develop their skills. Within 260 nursing undergraduates with experience in simulation practice as study subjects, a self-reporting survey was conducted on self-leadership, goal commitment, critical thinking, and problem-solving skills. An analysis was conducted using the SPSS/WIN 21.0 program. t-test and ANOVA were conducted to validate the difference between problem-solving abilities. Multiple regression was conducted to examine the impact of these variables on problem-solving skills. The variables of religion, satisfaction with major, goal commitment, and critical thinking were found to have a significant impact on problem-solving abilities. The results were as follows: critical thinking (β = 0.36, p < 0.05), goal commitment (β = 0.28, p < 0.05), and explanatory power of 41%. To improve the nursing undergraduates' problem-solving abilities through simulation practice, there needs to be a method that supports them in setting goals with self-leadership and enhance goal commitment. The method also needs to support the development of their critical thinking and curiosity for questions deriving from experiencing diverse programs in order to deliver effective outcomes.

Impact of Mental Health on Wellness in Adult Workers

Wellness in adult workers is intimately associated with better quality of life in individuals, as well as in the family, community, workplace, and country. This study aimed to examine the status of wellness in adult workers and to identify the factors that influence wellness. A descriptive survey was conducted with 260 adult workers. T- test and one-way ANOVA with post-hoc Scheffe test were used to analyze the data. Multiple regression analysis was performed on stress, depression, anxiety, well-being, self-efficacy, and perceived health status. The regression model for wellness in adult workers was significant (F = 42.21, p < 0.001), with an explanatory power of 0.558. Depression (β = −0.306) was identified as the most influential factor for wellness in adult workers, followed by self-efficacy (β = 0.280) and well-being (β = 0.264). Depression, stress, and anxiety negatively influenced wellness, whereas self-efficacy, well-being, and perceived health status positively influenced wellness. Study findings suggest the need to develop intervention programs for workers that decrease stress, depression, and anxiety, and incorporate self-efficacy strategies.

Development and Application of a Program for Reinforcing Global Health Competencies in University Nursing Students

Purpose: With globalization, the importance of global health is being stressed. Although nurses are indispensable healthcare professionals, programs to develop nurses with global health competencies and relevant studies are rare. Accordingly, this study was designed to develop a program to increase global health competencies and global leadership in nursing students and test its effect.

Methods: A single group pre- and post-test study design was used. A 13-weeks program was developed and implemented with 204 students. Data were analyzed using paired t-test. The program to promote global health competencies was designed to improve nursing students' knowledge of global health, global leadership, global health competencies, critical thinking ability, and student-student partnership.

Results: Global health competencies (t = −19.96, p < 0.001), self-assessed global leadership (t = −7.67, p < 0.001), and critical thinking ability (t = −7.67, p < 0.001) all significantly increased.

Discussion: The study findings of increased global health competencies and global leadership in nursing students after participation in the program indicated ways in which global health competencies of nurses need to be developed. Therefore, the following aspects should be considered. First, nursing educators should understand the need and importance of global health education and accordingly, current nursing curriculums should be revised to include courses about global health. A systematic course of studies about global health should be developed and implemented based on discussions among experts and researchers. Second, as future health care professionals, nursing students should take an interest in global health problems and recognize various issues that need to be solved beyond borders between countries. To develop global health competencies, various efforts and systematic curriculum revisions are necessary.

Evaluation of the Effectiveness of Mobile App-Based Stress-Management Program: A Randomized Controlled Trial

Improving mental healthcare using mobile apps might be an effective way to increase interest in mental health and respond to the demand for better psychological health. However, few studies have investigated the effectiveness of app-based stress-management programs. This study aimed to assess the efficacy of an app-based stress-management program. A non-equivalent comparison group pretest-posttest design was used. Participants were randomized into the experimental (n = 26) and control (n = 30) groups. The experimental group used an application developed for workers for four weeks. The results indicated that stress, emotional labor, self-efficacy, and well-being were significantly different in the experimental group, but the control group’s average scores did not change significantly. On average, the Perceived Stress Scale scores decreased by 1.5 points (p = 0.035) and the Korean Occupational Stress Scale scores decreased by 0.87 points (p = 0.4). However, depression and anxiety were not significantly different. Emotional labor decreased by 0.16 points (p = 0.027), and well-being and self-efficacy mean scores increased by 0.492 (p = 0.005) and 0.162 (p = 0.025), respectively. These findings support the developed application’s value for promoting mental health and healthy lifestyles. Further research and supplementation are needed for the application’s sustainability.

Application of a High-Throughput Enantiomeric Excess Optical Assay Involving a Dynamic Covalent Assembly: Parallel Asymmetric Allylation and Ee Sensing of Homoallylic Alcohols

Parallel synthesis and high-throughput ee screening.

Asymmetric Ir-catalyzed C–C coupling of primary alcohols with allyl-acetates, as described by Krische, to form chiral secondary homo-allylic alcohols were performed in parallel as a means to optimize the ee values thereof. Specifically, approximately 400 examples of this reaction were performed by varying the catalyst, added acids and bases, and starting reactants, to form 4-phenyl-1-butene-4-ol (1). The ee values for the transformations were determined in a high-throughput fashion using a 4-component assembly that creates a circular dichroism signal indicative of the extent of asymmetric induction. Further, a parallel and rapid quantitative TLC method measures the yield of each reaction, revealing which reactions give reliable ee values in the CD-based assay. Overall, the nearly 200 reactions whose ee values were determined could be quantitated in under two hours. Using a combination of the TLC method to measure yield with the CD-assay to measure ee values, several trends in reaction conditions were revealed. For example, it was found that the cyclometalated iridium catalyst modified by BINAP and m-nitro-p-cyano-benzoic acid delivered adduct 1 with the highest levels of enantiomeric enrichment (94%), whereas the corresponding SEGPHOS-modified catalyst gave a comparable yield but lower ee (91%). Most importantly, this study shows that supramolecular assemblies can report hundreds of ee values in a rapid and reliable fashion to analyze parallel synthesis routines.

Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

OBJECTIVES

To evaluate the usefulness of CA125 levels in the differential diagnosis of adenomyosis and myoma. This has been addressed by few, if any, previous studies.

STUDY DESIGN

Preoperative serum CA125 levels were measured in 2149 women who were diagnosed at total hysterectomy as having adenomyosis, myoma, endometriosis, and/or normal pelvis. Their medical records were retrieved and reviewed.

RESULTS

The mean serum CA125 level in the adenomyosis patients was significantly greater than that in the patients diagnosed with myoma (65.21±96.60 U/mL vs.12.86±14.23 U/mL, respectively; P<0.001). In the differential diagnosis of adenomyosis and myoma, the cut-off serum CA125 level with the highest accuracy (78.8%) and highest diagnostic value (61.2%) was 19 U/mL. Using this cut-off value, the negative predictive value was 69.5%, and the positive predictive value was 76.5%. These results are clearly superior to those of the empirical single cut-off value of 35 U/mL. Receiver operating characteristic curve analysis revealed the area under the curve for differentiating adenomyosis from myoma was 0.776, indicating good diagnostic performance.

CONCLUSION

In the differential diagnosis of adenomyosis and myoma, cut-off values for CA125, particularly the cut-off value of 19 U/mL, provide improved diagnostic performance. Serum CA125 testing can be performed during the initial screening of women with possible adenomyosis to differentiate this condition from myoma, although the diagnostic accuracy of using CA125 testing alone is limited.

Association of the nipple-areola complexes with age, parity, and breastfeeding in Korean premenopausal women

BACKGROUND

There is no standard method of measuring the nipple-areola complex or defining the normal range and the changes seen in this complex. Numerous factors are involved in the anthropometric characteristics of the nipple-areola complex.

OBJECTIVE

The purpose of this study was to evaluate the anthropometric characteristics of the nipple-areola complex related to age, parity, and breastfeeding in 234 premenopausal Korean women (468 breasts).

METHODS

This cross-sectional study was conducted from May 2011 to June 2012. Five parameters of both nipple-areola complexes were measured in volunteers who were placed in a supine position. The diameters of the nipple-areola complex and the nipple projection were measured using micrometer calipers.

RESULTS

The size of the nipple-areola complex increased according to age (P < .05). The measurements of the right nipple and the vertical diameter of the right areola were larger than those of the left sides in all age groups. There were no differences in the horizontal areola diameter and nipple projection between the 2 sides. The left horizontal areola diameter in breastfeeding parous women was larger than that in the non-breastfeeding parous women group (P = .011). The nipple projection was associated with the duration of breastfeeding (especially more than 12 months). The percentage of women with retracted nipples was 11.2%.

CONCLUSION

Our study may be helpful in understanding nipple-areola complex changes related to age, parity, and breastfeeding. These results should be evaluated with larger study cohorts and more longitudinal studies to better understand factors related to changes of the nipple-areola complex.

Pulmonary nodule registration in serial CT scans using global rib matching and nodule template matching

We propose an automatic nodule registration method between baseline and follow-up chest CT scans. Initial alignment using the center of the lung volume corrects the gross translational mismatch, and rigid registration using coronal and sagittal maximum intensity projection images effectively refines the rigid motion of the lungs. Nodule correspondences are established by finding the most similar region in terms of density as well as the geometrical constraint. The proposed nodule registration method increased the nodule hit rate (the ratio of the number of successfully matched nodules to total nodule number) from 26% to 100%.

Mullerian inhibiting substance induces apoptosis of human endometrial stromal cells in endometriosis

CONTEXT

Müllerian inhibiting substance (MIS) is produced in Sertoli cells of fetal testis and causes regression of müllerian ducts in male embryos. MIS also can induce the cell cycle arrest and apoptosis in müllerian duct-derived tumors in vivo and in vitro.

OBJECTIVE

Our objective was to investigate the expression of MIS type II receptor (MISR II) and whether MIS can inhibit the proliferation and induce apoptosis in primary cultures of endometrial stromal cells (ESC) of endometriosis.

DESIGN AND SETTINGS

In vitro experiments were performed in the university research laboratory.

PARTICIPANTS

Tissue samples from 12 patients who had undergone evisceration for ovarian endometrial cysts were included in this study.

INTERVENTIONS AND MAIN OUTCOME MEASURES

The expression of MISR II in ESC was investigated by immunohistochemistry. The cell viability and apoptosis in ESC treated with MIS was measured by methylthiazoletetrazolium assay and annexin V analysis. The expression of regulatory proteins in ESC treated with MIS was shown by Western blotting.

RESULTS

ESC showed specific immunostaining for the MISR II. ESC treated with MIS exhibited 32% growth inhibition (P = 0.0001). The changes in cell cycle distribution after MIS exposure at 72 h demonstrated that S and G(2)M phases were decreased; G(0)G(1) and sub-G(0)G(1) phases were increased. ESC treated with MIS showed 13.72% annexin V-fluorescein isothiocyanate positivity. In the ESCs, which contain defective p16, MIS increased the expression of pocket proteins p107 and p130 and decreased E2F transcription factor 1.

CONCLUSIONS

The results support a central role for MIS in endometriosis. Although the precise mechanism of MIS-mediated inhibition of ESC growth has not been fully defined, these data suggest that MIS has activity against ESC in vitro and may also be an effective targeted therapy for endometriosis.

Association between obesity, metabolic risks and serum osteocalcin level in postmenopausal women

BACKGROUND

Osteocalcin, a marker of bone formation, is also known as a regulator of glucose and fat mass. The purpose of this study was to determine the association between obesity, metabolic risks and serum osteocalcin in postmenopausal women.

METHODS

We selected 214 postmenopausal women and determined serum osteocalcin, fasting plasma glucose (FPG), fasting insulin, high-sensitivity C-reactive protein (hs-CRP), the homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, and anthropometric values (body mass index [BMI], waist-to-hip ratio [WHR], body fat, and visceral fat area [VFA]).

RESULTS

After adjustment for age and years since menopause, WHR and VFA were negatively correlated with serum osteocalcin, but BMI did not show a significant correlation. Serum osteocalcin was negatively correlated with fasting insulin and HOMA-IR, but FPG, lipid profile, and blood pressure did not show a significant correlation. Based on multiple regression analysis, age and HOMA-IR were the most important predictors of osteocalcin.

CONCLUSION

Our study showed that serum osteocalcin has some significance as an indicator of metabolic risk, including abdominal obesity and insulin resistance. Bone as well as adipose tissue may be an active organ that regulates energy metabolism. A larger study will be needed to clarify the potential of osteocalcin as an indicator of cardiovascular disease.

Association between metabolic syndrome and serum leptin levels in postmenopausal women

Menopausal status is associated with weight gain, increased central fat mass, abnormal lipid metabolism, insulin resistance and susceptibility to metabolic syndrome (MetS). Leptin is synthesised and secreted by adipocytes. Serum leptin levels are highly correlated with fat mass. We determined the association between MetS and serum leptin levels in 153 postmenopausal women. The difference in serum leptin level between MetS and non-MetS groups showed a statistical significance after adjusting for body mass index (BMI; 19.9 ± 9.5 vs 12.1 ± 5.9 ng/ml, p = 0.013). The indicator of abdominal obesity, waist-to-hip ratio (WHR) and visceral fat area (VFA), had a positive correlation with serum leptin level in non-obese subjects after adjusting for BMI (p = 0.017, p < 0.001, respectively). Of the components of MetS, abdominal obesity and the number of MetS components had a positive correlation with serum leptin level (p < 0.05, p < 0.001, respectively).

Expression of Müllerian inhibiting substance type II receptor and antiproliferative effects of MIS on human cervical cancer

This study aimed to analyze expression of Müllerian inhibiting substance type II receptor (MISRII) protein and mRNA in cervical neoplasia, to demonstrate the growth inhibition of cervical cancer cells by administration of highly purified recombinant human Müllerian inhibiting substance (MIS) and, furthermore, to evaluate the clinical significance of MIS as a biological modifier for MIS receptor expressing tumors. Reverse transcriptase polymerase chain reaction (RT-PCR) was used for MISRII mRNA expression, and in situ hybridization and immunohistochemistry were used to observe expression, location of MISRII mRNA and protein, respectively. To demonstrate the effect of MIS on the viability of cervical cancer cells, methyl thiazole tetrazolium (MTT) assay was performed. Flow cytometry was used to evaluate the cell cycle distribution after exposure to MIS in cervical cancer cells, and the annexin-V-FITC staining method was performed to demonstrate apoptosis by MIS in cervical cancer cells. Expression of MISRII protein and mRNA were observed in all normal cervical and cervical carcinoma tissues. There was no significant difference in expression of MISRII protein and MISRII mRNA between normal cervical and cervical carcinoma tissues. MTT assay showed negative correlation between MIS exposure time and the viability of cervical cells (P=0.008). The changes in cell cycle distribution after MIS exposure suggest that MIS plays an important role in inducing cellular apoptosis by causing arrest at the G1 phase and increasing cells at sub-G0G1 phase. Annexin-V-FITC staining methods showed that cellular apoptosis was, respectively, 10.44 and 12.89% after 24 and 48 h of MIS exposure in cervical carcinoma cells. There was a negative correlation between cellular survival and MIS exposure time. This study demonstrates that MISRII is present on normal cervical and cervical carcinoma tissues, and MIS shows receptor-mediated antiproliferative effect on cervical cells in vitro. These data suggest that MIS may be used as a biological modifier or therapeutic modulator on MISRII-expressing tumors in the future.

Association between menopausal symptoms and metabolic syndrome in postmenopausal women

PURPOSE

Menopausal symptoms are major concerns of postmenopausal women. Metabolic syndrome (MetS) is a risk factor for cardiovascular disease, and menopause is associated with an increased prevalence of MetS. The purpose of this study was to determine the association between menopausal symptoms and MetS in postmenopausal women.

METHODS

We selected 183 women who attended St. Vincent Hospital of the Catholic University of Korea in 2008 and 2009 and divided them into two groups (with and without MetS). Menopausal status was assessed with the Menopause Rating Scale (MRS) questionnaire. The body mass index and waist-to-hip ratio were determined, and the serum fasting glucose, lipid profile, and blood pressure were measured in all participants.

RESULTS

Of 183 postmenopausal women, 64 (35.0%) had MetS. A significant increase was observed in the total MRS score and the total somatic symptom subscale score in the MetS group (p = 0.021, p = 0.043, respectively). Vasomotor symptoms such as hot flashes and sweating occurred with higher frequency in the MetS group than in those without MetS (p = 0.034). High triglyceride levels and an increase of the number of components of MetS were associated with a higher total subscale score of somatic symptoms (p = 0.044, p = 0.039, respectively).

CONCLUSIONS

These results showed that a higher total subscale score and a higher frequency of somatic symptoms such as hot flashes and sweating were present in the MetS group. Larger scale studies are needed to clarify the association between other menopausal symptoms and MetS in postmenopausal women.