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Background: Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation. Research question/aim/objectives: This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice. Research design/Participants and research context: We surveyed the basic attributes of and used the Ode’s Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors. Ethical considerations: This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors’ permission. Findings/results: Significant differences were found in the mean “ethical behavior” scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the “justice” subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without. Discussion: Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience. Conclusion: Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences.

In this study, we analyzed the CYP3A inhibitory components of star fruit Averrhoa carambola L., using liquid chromatography-mass spectrometry (LC-MS). The stereoisomer of procyanidin B1 and B2 and/or the trimer consisting of catechin and/or epicatechin were suggested to be potent inhibitory components.

Treatment of proximal humeral fractures is very challenging in elderly patients with osteoporosis. Difficulty in obtaining a stable osteosynthesis remains the main problem for the surgeon. Knowing more details about the bone quality of the humeral head can be helpful for treatment. The purpose of this study was to evaluate the bone quality of the humeral head based on age, sex, and location. Three groups of patients were identified according to age: group A (aged30 years), group B (aged40 years but60 years), and group C (aged60 years). Computed tomography (CT) was performed on each patient to evaluate the humeral head bone quality. The distribution of bone density was assessed by the CT value expressed in Hounsfield units. The maximum, minimum, and mean CT values were calculated in the cancellous bone of the humeral head for each image. The humeral head was then divided into 3 equal zones, and a map of the 3 zones was made. The results showed that there was a significant difference between men and women in our series with regard to the percentage of bone tissue. There was also a significant difference among the 3 groups (age-related), as well as between the medial and lateral sides, with regard to the percentage of bone tissue. Osteopenic change in the humeral head has a negative correlation with aging. The medial side, especially the articular side, has more bone tissue than other areas. These results suggest that, when we treat humeral head fractures of elderly patients, we need to define bone quality for each case. We should then take care when establishing the site and angle of insertion for fixation to obtain optimal fixation on the lateral side.

Erythrocyte acid phosphatase (EAP), esterase D (ESD) and phosphoglucomutase (PGM) phenotypes among the erythrocyte enzyme types of blood groups are surveyed and a modified cellulose acetate membrane isoelectric focusing (CAM-IEF) method for their exploration is described. The phenotyping procedures are usually classified as either equilibrium or non-equilibrium IEF. Equilibrium IEF, which is based on differences in pI values, includes three methods: (i) a narrow pH range of carrier ampholytes, (ii) a relatively narrow pH range of carrier ampholytes containing chemical separators and (iii) immobilized pH gradient gels. Among the three methods, immobilized pH gradients provide a better resolution of isozymes. Conversely, the disadvantages of immobilized pH gradients include longer focusing times and complex gel preparations. Moreover, immobilized pH gradients are unsuitable for stain analysis because of the insensitivity of PGM1 detection. A hybrid IEF system and a commercial immobilized pH gradient dry plate have overcome these problems. However, EAP typing is extremely expensive and ESD typing is not well distinguished by hybrid IEF. As each method has both merits and demerits, the most suitable technique should be selected based on the kind of erythrocyte enzyme types and sample conditions. On the other hand, non-equilibrium IEF is a rapid method because isozymes are detected on the basis of their charge differences under non-equilibrium conditions. Moreover, the appropriate addition of chemical separators increases the charge difference and provides a good resolution within a shorter time. Addition of more separators produces a narrow pH range in the gel and takes a substantially longer time to reach the optimum pH range for charge difference. Further, the viscosity due to the excess addition of separators results in poor reproducibility for high-field-strength CAM-IEF. Hence the amount of chemical separators is taken into consideration of obtaining optimum results. If the optimum conditions are established with primary experiments, the combination of chemical separator and non-equilibrium IEF is proposed as a readily available method for routine analysis of erythrocyte enzyme types in forensic science.

The relationship between spontaneous pregnancy of hyperprolactinemic patients after a first pregnancy induced by treatment and their serum prolactin levels was examined. Of the 100 patients with hyperprolactinemia studied, 74 became pregnant after treatment; namely, 20 transsphenoidal adenomoidectomy for pituitary prolactinoma (group 1), 26 on treatment with bromocriptine for pituitary prolactinoma (group 2), and 28 on treatment with bromocriptine for hyperprolactinemia without prolactinoma (group 3). After delivery in the first pregnancy, the rates of menstrual restoration and subsequent spontaneous pregnancy in group 1 (72.2% and 75.0%) were significantly (p less than 0.05) higher than those in group 2 (32.0% and 25%) and group 3 (13.6% and 18.2%). The serum levels of prolactin after the first pregnancy and weaning were significantly (p less than 0.05) lower in patients with subsequent spontaneous pregnancy than in patients without spontaneous pregnancy in each group, and the levels in patients with spontaneous pregnancy were significantly (p less than 0.05) lower in group 1 (15.2 +/- 8.8 ng/ml) than in group 2 (46.6 +/- 2.9 ng/ml). These data suggest that the transsphenoidal adenomoidectomy for pituitary prolactinoma may be better than bromocriptine treatment for recovery of reproductive function.

The gene encoding the specific glycosyltransferases which catalyze the conversion of the H antigen to A or B antigens shows a slight but distinct variation in its allelic nucleotide sequence and can be divided into 6 genotypes when digested with specific restriction enzymes. We extracted DNA from formalin-fixed, paraffin-embedded tissues using SDS/proteinase K treatment followed by phenol/chloroform extraction. The sequence of nucleotides for the A, B and O genes was amplified by the polymerase chain reaction (PCR). DNA fragments of 128 bp and 200 bp could be amplified in the second round of PCR, using an aliquot of the first round PCR product as template. Degraded DNA from paraffin blocks stored for up to 10.7 years could be successfully typed. The ABO genotype was deduced from the digestion patterns with an appropriate combination of restriction enzymes and was compatible with the phenotype obtained from the blood sample.

Forty-six cases of child abuse/neglect autopsied during the period of 1967 to 1990 were investigated. The weight and histological findings of the thymus were compared with those of control children. In most abused and/or neglected children, the weight of the thymus decreased conspicuously. Involution correlated well to the degree and period of maltreatment. In cases without weight loss of the thymus, i.e. spasmodic abuse by a mentally deranged parent or foster parent, a short history of maltreatment was noted. On the other hand, marked involution was observed in cases of prolonged physical abuse and/or neglect. Microscopically, a decrease in the number and pyknosis of lymphocytes were observed in the involuted thymus. Atrophy of the thymus was more conspicuous in the cortex than in medulla. Immunohistochemically, CD-1a positive cells (immature thymocytes) decreased in cases with thymic involution. This involution appears to be an important index of the degree and duration of child abuse/neglect. Furthermore, thymic involution in the early stage of childhood may also be related to insufficiency of the immune system.

The localization of ABH related antigens in human male reproductive tract was examined using monoclonal antibodies and an avidin biotin complex method. No positive reaction with blood group antibodies on spermatozoa was observed in testis and ductus epididymidis apart from erythrocytes and endothelial cells. The expression of ABH and ABH related antigens in ductuli efferentes testis, ductus epididymidis, seminal vesicle and prostate was complexly coded by a combination of H, Se, Le and X genes. The results obtained in this study indicate that the ABH antigens detected on spermatozoa of seminal stains are coating antigens and not inherent to the cell membrane, and the ABO, H, Se, Le and X genes are subjected to a tissue-dependent differential expression.

Phenotyping of erythrocyte acid phosphatase (EAP) and esterase D (ESD) by cellulose acetate membrane isoelectric focusing (CAM-IEF) under a nonequilibrium condition is described. In an attempt to improve the method of CAM-IEF, we shortened the electrode distance to provide a higher field strength at a given (low) voltage. Various carrier ampholytes for EAP typing and various chemical separators for ESD typing were also tested. Good separations were obtained after 30 min IEF for EAP typing and 25 min for ESD typing. When applied to blood stains and stored for various periods at room temperature, the stains up to 8 months old could still be phenotyped for EAP and those up to 4 weeks old for ESD. CAM-IEF is suitable for routine forensic work of EAP and ESD phenotyping.