No abstract available.
Diethylstilbestrol* ; Female ; Humans ; Lymphocytes* ; Siblings* ; Sister Chromatid Exchange*

We evaluated the effect of M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) chemotherapy in 63 patients with invasive transitional cell carcinoma of the bladder between January 1987 and December 1993. The patients consisted of 59 male and 4 female. Patient age ranged from 35 to 80 years with a mean of 61.5 years. All patients were given 1-7 cycles(mean 2.7 cycles) of M-VAC chemotherapy and followed for 1 to 8 years. Ten patients(16%) achieved a clinical complete remission(CR), 22(35%) partial remission(PR), 11(17.5%) minor response(MR), 11(17.5%) stabilization(STAB), and 9(14%) progression(PROG). The overall clinical response rate was 51%. Of 22 patients who underwent surgery(radical cystectomy in 15, partial cystectomy in 7), 3 patients(14%) achieved objective pathologic response. The estimated 5-year survival rate according to response of primary tumor to chemotherapy was 86%, 55% in patients with response and non-response, respectively. This difference between the groups was statistically significant(P<0.05). Overall 3-years and 5-years survival rates were 73% and 71%, respectively, and mean survival was 3.1 years. The toxicity of the regimen was generally acceptable, but 79% of the patients experienced myelosuppression, 8% hepatic toxicity and 6% stomatitis. In conclusion, the patients who achieved a clinical response seem to have a better prognosis and neoadjuvant M-VAC chemotherapy may result in bladder preservation for selected patients with muscle invasive bladder cancer.
Carcinoma, Transitional Cell ; Cystectomy ; Doxorubicin* ; Drug Therapy ; Female ; Humans ; Male ; Prognosis ; Stomatitis ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine*

PURPOSE: The purpose of this phenomenological study was to explore neonatal intensive care unit (NICU) nurses' experience in caring for infants who are approaching death and to identity the meaning and structure of their experiences. METHODS: The participants were eight nurses who had experience in caring for these infants. In-depth interviews were performed from December, 2012 to February, 2013 until data were fully saturated. Collected data were analyzed using Colaizzi's method. RESULTS: Four theme clusters were extracted from fifteen themes. The four theme clusters of the NICU nurses' experience in caring for infants who are dying were: 1) Crossroads between life and comfort of infants approaching death, 2) emotional suffering at the death of the infant, 3) adapting and coping with the death of the infant, 4) new expectations for caring for infants who are dying. CONCLUSION: The results of the study provide useful information in understanding NICU nurses' experience in caring for infants who are dying and establishing effective strategies to support these nurses.
Humans ; Infant* ; Infant, Newborn ; Intensive Care, Neonatal* ; Neonatal Nursing

PURPOSE: This study aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. METHODS: The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis. RESULTS: The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely “personal growth” and “professional growth”, and ten sub-themes. CONCLUSION: The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses.
Critical Care* ; Humans ; Intensive Care Units* ; Nursing ; Program Development

In order to assess the efficiency of Percoll gradient centrifugation(PGC) as a method of sperm selection, we have examined morphological characteristics of spermatozoa from 40 teratozoospermic patients attending the Infertility Clinic of Inchon Gil Gerneral Hospital. Patients were divided into three groups according to percentage normal morphology in the fresh sample : group A(n=5), < 5% normal morphology : group B(n=21), 5~14% normal morphology : and group C(n=14), > 14% normal morphology. Morphology slides were perpared using Diff-Quik staining techniques and evaulated by Kruger strict criteria, under oil immersion at a magnification of X 1000, specific defects, head, neck and tail were assesed individualy. The results were as follows. 1. Following PGC, sperm samples with enhanced morphology were recovered for all groups. 2. For group A, PGC did not select a sample with significantly improved morphological characteristics. 3. Usually, sperm defects affected by PGC was head and neck. No significant difference was found for tail abnormality. In conclusion, Percoll gradient centrifugation is an efficient sperm preparation technique when the semen sample exhibits teratozoospermia, especially head or neck abnormality. However, in sample with < 5% normal form or tail abnormality, There is not significant improvement following PGC.
Centrifugation* ; Equidae ; Head ; Humans* ; Immersion ; Incheon ; Infertility ; Neck ; Semen ; Spermatozoa*

PURPOSE: This study was conducted to explore relationships of postpartum depression with socio-demographic and clinical characteristics of preterm infants and mothers. METHODS: Participants were the mothers of 80 premature infants admitted to neonatal intensive care units. Postpartum depression was measured using the Edinburg Postnatal Depression Scale (EPDS). Clinical characteristics were examined through the medical records. The physiological state for the infants was evaluated using the revised Neurobiologic Risk Score (NBRS). Data were analyzed using the t-test, ANOVA, and Pearson correlation coefficients. RESULTS: Average for EPDS was 9.75+/-5.06, and 30% of the participants were at high risk for postpartum depression. There were significant differences in postpartum depression according to mother's education level (F=3.493, p=.035), economic state (F=5.828, p=.004), multiple pregnancy (t=2.141, p=.037), chorioamnionitis (t=2.349, p=.021), oligohydramnios (t=-2.226, p=.029), broncho-pulmonary dysplasia (t=2.085, p=.040), germinal matrix hemorrhage (t=2.259, p=.027), and revised NBRS (t=-2.772, p=.007). There was a significant positive correlation between postpartum depression and number of health problem of infants (r=.252, p=.024) and revised NBRS (r=.316, p=.004). CONCLUSION: As 30% of the mothers with preterm infants were at high risk for postpartum depression, they require attention. When providing interventions, socioeconomic status as well as the physiological state of premature infants should be considered.
Chorioamnionitis ; Depression, Postpartum* ; Education ; Female ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units, Neonatal ; Medical Records ; Mothers* ; Oligohydramnios ; Pregnancy ; Pregnancy, Multiple ; Social Class

No abstract available.
Pericardial Effusion*

BACKGROUND: Neointimal hyperplasia, as the most important mechanism of restenosis after intracoronary artery stenting, its severity is closely correlated with the degree of local inflammatory reaction initiated by vasular injury during stenting procedure. So, we proceeded this study to determine whether inflammatory markers such as CD11b/CD18 (Mac-1) adehsion molecules of neutrophils, sICAM-1 (soluble intercellular adhesion molecule-1), ESR, and CRP increase or not in the peripheral circulation after coronary artery stenting, and whether there is any association between these findings and the degree of later restenosis. METHOD: 32 patients (chronic stable angina 4, unstable angina 17, acute myocardial infarction 11) underwent single vessel coronary artery stenting were enrolled in our study. Blood samples were obtained from peripheral vein just before coronary artery stenting and 48 hours thereafter. The degrees of CD11b/CD18 expression on the surface of neutrophils were analyzed by flow cytometry with monoclonal antibodies, and sICAM-1 by ELISA method. At each times, ESR and CRP were also measured. Follow-up coronary artery angiography was performed with QCA analysis at least 6 months later. We compared the each 48 hours values with the baseline (just before procedure) values. Percentage increments (as a ratio 48 hours values to baseline) of CD11b/CD18 expression, sICAM-1, ESR, and CRP levels were also compared with the results of follow-up QCA analysis. RESULTS: Restenosis (diameter stenosis > or = 50%) occurred in 6 patients (19%) at follow up angiography. 48 hours values of CD11b/CD18 expression, sICAM-1, ESR, and CRP were significantly elevated from the baseline values (each p values, CD11b : < 0.0001, CD18 : 0.01, sICAM-1 : < 0.0001, ESR : 0.005, and CRP : 0.001). The percentage increments of CD11b/CD18 expression were more elevated in restenosis group than nonrestenosis group (CD11b : 341+/-215%/74+/-95%, CD18 : 84+/-60%/17+/-37%, each p < 0.001, 0.001). There was some positive correlation between the percentage increments in the expression of CD11b and the late loss index at the follow up angiography (r=.43, p<0.05). CONCLUSIONS: Through this study, we found that the activation of neutrophils was occurred, and that sICAM-1 level was increased after coronary artery stenting in the peripheral blood. There was some correlations between the degree of CD11b expression on the surface of neutrophils and the severity of late lumen loss of inserted stents. The measurements of increased neutrophil adhesion molecules of CD11b/CD18 levels at 48hrs after coronary stenting may have a value as the predictor of subsequent late restenosis.
Angina, Stable ; Angina, Unstable ; Angiography ; Antibodies, Monoclonal ; Arteries ; Constriction, Pathologic ; Coronary Vessels* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Follow-Up Studies ; Humans ; Hyperplasia ; Myocardial Infarction ; Neutrophils* ; Stents* ; Veins

PURPOSE: The purpose of this study was to validate the Korean version of the TNO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire for children aged 18-60 months. METHODS: The participants were 223 mothers of healthy children from nurseries and kindergartens, and 54 mothers of hospitalized children from a university children's hospital in Korea. Data were collected in 2011. Principal component factor analysis and known-groups method were used to confirm construct validity, and internal consistency was used to determine reliability. RESULTS: According to the factor analysis, 11 factors with an eigenvalue over 1 were extracted, and these factors explained 73.5% of the variance. All dimensions except two had Cronbach's alpha coefficients greater than .7. The mean TAPQOL scores of the hospitalized group were significantly lower than those of the healthy group (p=.001) for all four functions (physical, emotional, social, and cognitive). CONCLUSIONS: The TAPQOL showed acceptable validity and reliability, and can be used to measure children's health-related quality of life in Korea, and can be considered for use in other Asian countries.
Asian Continental Ancestry Group ; Child* ; Child, Hospitalized ; Child, Preschool ; Humans ; Korea ; Mothers ; Nurseries ; Quality of Life* ; Reproducibility of Results ; Translations ; Surveys and Questionnaires

The effects of intravenous Verapamil administration on ventricular function were evaluated using grated radionuclide ventriculography in 15 patients with essential hypertension. Verapamil(0.1mg/kg) was injected as a bolus for 2 minutes followed by an infusion of 0.007mg/kg/min. Heart rate, blood pressure, ejection fraction, peak ejection rate, total filling time, and prak filling rate were assessed before and after Verapamil administration. The results were was as follows ; 1) Verapamil administration increased heart rate from 63+/-5 to 75+/-9 beats/min(p<0.01) and reduced systolic and diastolic blood pressure from 156+/-17/99+/-6mmHg to 139+/-16/88+/-6mmHg(p<0.01). 2) Ejection fraction, peak ejection rate, and total filling time were not changed significantly after Verapamil injection. 3) Right and left ventricular peak filling rate increased significantly only in patients in whom it was subnormal in the basal study) from 1.6+/-0.4 to 2.3+/-1.1 end-diastolic volumes/s, p<0.05 and from 2.5+/-0.6 to 3.1+/-0.8 end-diastolic volumes/s, p<0.05, respectively). In conclusion, it was found that intravenous Verapamil administration enhances ventricular diatolic function in patients with essential hypertension.
Blood Pressure ; Heart Rate ; Humans ; Hypertension* ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Right* ; Verapamil*