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*

Tumor necrosis factor-n (TNF - alpha) involved in the pathogenesis of multiple sclerosis and contribute to the degeneration of oligodendrocytes as well as neurons. TNF - alpha is produced by miocroglia and astrocytes, which also produce hormones and cytokines that influence its biological activity. Astrocytes, the major glial cells in the CNS, are capable of producing TNF - alpha at both the mRNA and protein levels in response to interleukine-1 (IL-1) or TNF - alpha. Two immunosuppressive cytokines, transforming growth factor - beta (TGF - beta) and IL-10, have been shown to influence glial cell function. TGF - beta can modulate the activity of glial cells by inhibiting interferon-gamma (IFN - gamma) induced expression of class II major histocompatibility complex (MHC) molecules on astrocytes and microglia. To explore the role of astrocytes in the production of TNF - alpha, astrocytes were pretreated with IL-10 or TGF - beta and then stimulated with IL-1p to determine their effects on TNF - alpha production. The secretion of TNF - alpha by human fetal astrocytes was markedly inhibited by TGF - beta at a low concentration. In contrast IL-10 had no effect on TNF - alpha mRNA level. These results show that TGF - beta may regulate the expression of TNF - alpha in activated human fetal astrocytes.
Astrocytes* ; Cytokines ; Gene Expression* ; Humans* ; Interferon-gamma ; Interleukin-10 ; Major Histocompatibility Complex ; Microglia ; Multiple Sclerosis ; Necrosis ; Neuroglia ; Neurons ; Oligodendroglia ; RNA, Messenger ; Transforming Growth Factors

BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications, unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcome and the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery. METHODS: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from January to December 2011. RESULTS: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors (body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion [p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediately following surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortality in univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p < 0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p < 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors. CONCLUSIONS: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered important predictors of mortality.
Abdomen* ; Body Mass Index ; Humans ; Critical Care ; Intensive Care Units ; Length of Stay ; Mortality ; Postoperative Complications ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Serum Albumin ; Ventilation

PURPOSE: This study was carried out to suggest methods for improving school health promotion programs by investigating the daily activities and the performance level of environment management, the awareness of importance, and opinions on the revision of and knowledge about laws and regulations related to school health promotion programs. METHOD: The subjects of this study were 289 school nurses in Gyeongsangbuk-do. The survey used a questionnaire containing 90 questions developed by the present researcher. Data were collected from July 5 to July 21, 2006 and analyzed using SPSS 12.0 for Windows. RESULT: 1. Regular check-up and drinking water management got the highest score in performance level. Sexual health and drinking water management got the highest score in the awareness of importance. 2. School nurses were aware of laws and regulations related to their clients (0.93), and the revision opinion was high on the whole (3.58). 3. According to general characteristics, the more educated school nurse were (F=6.80, p=.001) and the fewer students their school had (F=4.66, p=.010), the higher their performance level in daily activities was. The shorter their career in their work was (F=4.86, p=.008), the fewer classes their school had (F=5.04, p=.007) and the fewer students their school had (F=3.83, p=.023), the higher their awareness of importance was. 4. There was not any difference in the performance level of environment management according to general characteristics. The awareness of importance was highest in school nurses with experience less then ten years (F=3.66, p=.027). 5. There was not any difference in knowledge about laws and regulations according to general characteristics. The revision opinion was high in school nurses at schools with less than 18 classrooms (F=6.04, p=.003) and less than 500 students (F=4.24, p=.015). CONCLUSION: When school nurses perform school health promotion programs actively and vigorously, the students can be healthy and national health promotion can be actualized fundamentally.
Drinking Water ; Gyeongsangbuk-do ; Health Promotion ; Humans ; Jurisprudence ; Reproductive Health ; School Health Services* ; School Nursing ; Social Control, Formal ; Surveys and Questionnaires

PURPOSE: This study was conducted to identify the factors affecting nursing students' attitudes toward nurse-physician collaboration. METHODS: The subjects were 200 nursing students from a college in K city, and the participants were recruited by posting a recruitment announcement. Data were collected from June 26 to 29, 2018 and analyzed using SPSS 22.0 and descriptive statistics, t-test, ANOVA, Sheffé test, Pearson's correlation coefficients, and hierarchical multiple regression. RESULTS: Attitudes toward nurse-physician collaboration showed a statistically significant difference according to grade, the reflection of opinion within the family, and the number of the counselor in general characteristics. Assertiveness and attitudes toward nurse-physician collaboration showed weak positive correlation (r=.18, p=.011). In hierarchical multiple regression analysis, the most affecting factor was junior grade (β=.25), followed by positive assertiveness (β=.18) and the number of the counselor (β=.14). These variables explained 12.0% of the total variance in attitudes towards nurse-physician collaboration. CONCLUSION: To create positive attitudes toward collaboration between nurses and physicians in nursing students, various educational programs related to assertiveness on communication skills need to be provided from the lower grades. Also, a multidisciplinary simulation program should be developed and applied to be able to experience the situation of nurses and physicians.
Assertiveness* ; Cooperative Behavior* ; Counseling ; Humans ; Nursing* ; Students, Nursing*

Adolescent ; Animals ; Bites and Stings ; Burns ; Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Contracture ; Dentures ; Humans ; Lip ; Mastication ; Microstomia ; Mouth ; Mouth Mucosa ; Oral Hygiene ; Palate ; Recurrence ; Skin

No abstract available.
Diagnosis*

No abstract available.
Astrocytes* ; Gene Expression* ; Humans* ; Polymerase Chain Reaction*

No abstract available.
Astrocytes* ; Humans*

No abstract available.
Diagnosis* ; Polycystic Kidney Diseases*